The effect of intramyometrial injection of terlipressin versus carbetocin on hemoglobin and blood loss during open myomectomy operations without using haemostatic tourniquets: Double blinded randomized placebo-controlled trial
Uterine fibroids are a significant worldwide health problem due to their high prevalence among women during the reproductive period. Conservative surgery such as myomectomy has been of increasing interest. However, intraoperative blood loss represents a challenge to the surgeons. Therefore, the aim of this study was to assess the efficacy of Intramyometrial injection of terlipressin and carbetocin in reducing intraoperative bleeding and preserving the hemoglobin level. We conducted the randomized, double-blind, placebo-controlled trial from February 2022 to April 2024, in the El-Resala and Al-Aseema hospitals under the direction of the National Research Center. A total of 99 eligible female patients out of 119 (13werenotmeetingtheinclusioncriteria) with uterine fibroid were recruited into the study and allocated into three groups (n = 33): terlipressin group (A), carbetocin group (B), and saline group (C). Blood loss was significantly different among groups (P < 0.001), being significantly lower in the Terlipressin group than the carbetocin group (mean = 321 vs 418 ml) and significantly lower in both groups than the saline (mean = 969 ml). The Terlipressin group required significantly less blood transfusion than the saline group (P < 0.05). The operative time and side effects were not statistically different among the three groups (P < 0.05). The operative time and side effects were not statistically different among the three groups. Our study provided evidence that terlipressin is effective in reducing blood loss during myomectomy with advantages over carbetocin. Based on our results, we recommend the adoption of terlipressin to improve myomectomy outcomes and enhance patient safety, further studies with a larger sample size is recommended to confirm our findings.
