宫腔镜子宫肌瘤切除术中术中催产素输注对冲洗液吸收的影响:一项随机安慰剂对照双盲试验

Pub Date : 2022-06-20 DOI:10.15296/ijwhr.2022.26
H. Pourfathi, S. Atashkhoei, B. Naghipour, Rasool Hesam Amini, Leila Kafshdooz
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引用次数: 0

摘要

目的:子宫平滑肌瘤是女性最常见的良性肿瘤之一。子宫肌瘤切除术期间大量的液体吸收可能导致严重的问题,如容量过载和低钠血症。目的是观察术中催产素输注对宫腔镜子宫肌瘤切除术患者灌洗液吸收的影响。材料和方法:在这项随机、双盲的临床研究中,对50名25-45岁接受宫腔镜子宫肌瘤切除术并接受美国麻醉医师学会I级或II级认证的女性进行了评估。催产素组(S组)以125 mL/h的速度给予含有15单位催产素的250 mL林格液。安慰剂组(P组)给予等量生理盐水1.5 mL林格液。术中及24小时后评估术中血流动力学改变、液体亏缺、血红蛋白、红细胞压积、钠和白蛋白水平较基线降低、并发症和给药溶液毒性的发生率。结果:S组灌洗液量显著减少(P=0.021),灌洗液量减少(P=0.001)。接受催产素治疗的个体发生低血压的频率与安慰剂组没有显著差异(P=0.26)。S组血清红细胞压积(P=0.036)和钠(P=0.026)均显著降低。结论:宫腔镜子宫肌瘤切除术术中催产素输注可能与冲洗液吸收减少及随之而来的问题有关。因此,这种方法可能会降低宫腔镜子宫肌瘤切除术期间大量冲洗液被吸收的风险。
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The Effect of Intraoperative Oxytocin Infusion on Irrigation Fluid Absorption During Hysteroscopic Myomectomy: A Randomized Placebo-Controlled Double-Blind Trial
Objectives: One of the most prevalent benign tumors in women is uterine leiomyoma. Large quantities of fluid absorbed during myomectomy may cause serious problems such as volume overload and hyponatremia. The aim was to see how intraoperative oxytocin infusion affected irrigation fluid absorption in individuals having hysteroscopic myomectomy. Materials and Methods: 50 women between 25-45 years who underwent hysteroscopic myomectomy and had an American Society of Anesthesiologists class I or II were evaluated in this randomized, double-blind clinical trial study. A 250 mL ringer solution containing 15 units of oxytocin was administered at a 125 mL/h in the oxytocin group (group S). In contrast, the placebo group (group P) received 1.5 mL of normal saline in the same amount of Ringer solution. Intraoperative hemodynamic alterations, fluid deficit, decreased hemoglobin, hematocrit, sodium, and albumin levels from baseline, complications, and the incidence of toxicity with the administered solutions were assessed intraoperative and 24 hours later. Results: Group S had considerably reduced irrigation fluid volume (P=0.021) and volume deficit (P=0.001). The frequency of hypotension in individuals receiving oxytocin did not differ significantly from the placebo group (P=0.26). In group S, serum hematocrit (P=0.036) and sodium (P=0.026) were decreased significantly. Conclusions: Intraoperative oxytocin infusion during hysteroscopic myomectomy may be associated with reduced irrigation fluid absorption and the problems that come with it. As a result, this approach might decrease the risks associated with high amounts of irrigation fluid being absorbed during hysteroscopic myomectomy.
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