Departments of Anesthesia (Drs. Guo, Jiao, L. Xu, and Xinzhong).
Gynecology (Drs. K. Xu, Yang, Huang, and Lu), Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
J Minim Invasive Gynecol. 2021 Dec;28(12):2073-2079. doi: 10.1016/j.jmig.2021.06.008. Epub 2021 Jun 18.
To determine the optimal effective dose of pituitrin in laparoscopic myomectomy for uterine leiomyoma.
Double-blinded, randomized controlled trial.
Tertiary women's hospital in China.
Total of 118 patients who underwent laparoscopic myomectomy.
Patients randomly received 0, 2, 4, or 6 units of pituitrin injected into the myometrium surrounding the myoma.
Rate of satisfactory surgical condition, hemodynamic changes, total surgical time, and blood loss were recorded. The rates of satisfactory surgical conditions were 6.7%, 72.4%, 89.7%, and 93.3% in groups 0U, 2U, 4U, and 6U, respectively; they were higher in groups 2U, 4U, and 6U than those in group 0U, but there were no significant differences among the groups 2U, 4U, and 6U. The blood loss was higher in group 0U than that in groups 2U, 4U, and 6U (p < .01). Pituitrin was associated with a transient decrease in blood pressures and an increase in heart rate in a dose-dependent fashion, with more pronounced changes in groups 4U and 6U, and these groups also required a higher amount of vasoactive drug to correct hemodynamic changes (p < .05).
Two units of pituitrin could provide a satisfactory surgical field with minimal hemodynamic changes for laparoscopic uterine myomectomy.
确定垂体后叶素在腹腔镜子宫肌瘤剔除术中的最佳有效剂量。
双盲、随机对照试验。
中国一家三级妇女医院。
总共 118 名接受腹腔镜子宫肌瘤剔除术的患者。
患者随机接受 0、2、4 或 6 单位垂体后叶素注射到肌瘤周围的子宫肌层。
记录满意的手术条件、血流动力学变化、总手术时间和出血量。0U、2U、4U 和 6U 组的满意手术条件率分别为 6.7%、72.4%、89.7%和 93.3%；2U、4U 和 6U 组明显高于 0U 组，但 2U、4U 和 6U 组之间无显著差异。0U 组出血量高于 2U、4U 和 6U 组（p<.01）。垂体后叶素呈剂量依赖性地降低血压和增加心率，4U 和 6U 组变化更为明显，这两组也需要更多的血管活性药物来纠正血流动力学变化（p<.05）。
腹腔镜子宫子宫肌瘤剔除术中，2 单位垂体后叶素可提供满意的手术视野，且血流动力学变化最小。
