THE EFFECT OF DILUTE VASOPRESSIN SOLUTION ON BLOOD-LOSS DURING OPERATIVE HYSTEROSCOPY - A RANDOMIZED CONTROLLED TRIAL

Objective: To assess the effect of intracervical injection of dilute ( 0.05 U/mL) vasopressin solution on blood loss during operative hystero scopy. Methods: In a randomized, double-blind study, dilute vasopressi n solution or placebo (normal saline) was injected into the cervical s troma of 106 women before dilation of the cervix in preparation for op erative hysteroscopy. Intraoperative bleeding was calculated by dividi ng the number of red blood cells per milliliter of outflow distention fluid by the number of red blood cells per milliliter of the woman's b lood immediately before the procedure and multiplying this quotient by the total amount of outflow fluid collected. Pressures were kept cons tant with a hysteroscopic infusion pump. Results: The mean (+/- standa rd error of the mean) intraoperative blood loss of the treated (vasopr essin) and control (placebo) groups was 20.3 +/- 4.1 mL (range 0-135) and 33.4 +/- 5.4 mL (range 0-290), respectively. The volume of distent ion fluid intravasation in the treated and control groups was 448.5 +/ - 47.0 mL, (range 30-1410) and 819.1 +/- 79.7 mL (range 20-1977), resp ectively. The operating time in the treated and control groups was 31. 1 +/- 1.2 minutes (range 18-52) and 34.1 +/- 1.3 minutes (range 19-65) , respectively. For all three outcome measures, the differences betwee n the two groups were statistically significant, but for visual clarit y of the uterine cavity during surgery, the difference was not signifi cant. Conclusion: Administration of dilute vasopressin solution (0.05 U/mL) to the cervical stroma significantly reduces blood loss, distent ion fluid intravasation, and operative time during hysteroscopy. Furth er evaluation is required to determine the optimum dosage.