Efficacy and Safety of Perioperative Use of Epinephrine for Laparoscopic Myomectomy in Infertile Women with Symptomatic Solitary Intramural Uterine Fibroids A Randomized Clinical Trial.

Objective: To determine the efficacy and safety of intramyometrial application of epinephrine during a laparoscopic myomectomy in women of reproductive age desiring pregnancy and with clinically symptomatic uter- ine fibroids, in comparison with a placebo-based patient control group.

Study Design: The study group (n=96, 53.3%) underwent an application of 12 μg epinephrine hydro- chloride diluted in 20 mL of NaCl solution, while the control group (n=84, 46.7%) received 20 mL of NaCl only. Perioperative blood loss, duration of surgery, length of hospital stay, and incidence of perioperative and postoperative complications were evaluated.

Results: A significantly lower blood loss (mean ±SD: 57± 23 mL) was observed in the group with local appli- cation of epinephrine as compared to the control group (143±106 mL) (p<0.001), along with a significantly shortened duration of surgery (53 ±16 min) vs. control group (72±26 min) (p=0.006), and a significantly shortened hospital stay (3.0± 1.2 days) vs. the control group (4.3 ±1.4 days) (p= 0.003). No serious perioper- ative complications were observed in either group, and no statistically significant difference in the incidence of postoperative complica- tions was recorded with our study group when compared to the control group (2.1% vs. 7.1%) (p=0.143).

Conclusion: Epineph- rine use during a laparo- scopic myomectomy is both effective and safe.