COMPARATIVE STUDY BETWEEN OXYTOCIN VERSUS TRANEXAMIC ACID AND ETHAMSYLATE COMBINATION IN REDUCING INTRAOPERATIVE BLOOD LOSS IN MYOMECTOMY

Abstract

Background: Fibroids are the most common benign pelvic tumors affecting about 20% of women above 35 years of age. The diverse symptomatology of fibroids can be attributed to size, number and location of the tumors. The common symptoms include menorrhagia, infertility, abdominal mass and pressure effects. Objective: To compare the efficacy of tranexamic acid and ethamsylate versus IV oxytocin infusion in reducing blood loss during abdominal myomectomy. Patients and Methods: This study involved ninety women undergoing abdominal myomectomy for symptomatic uterine myoma divided randomly into three equal groups: Group A (Tranexamic acid and ethamsylate group) received 1 g tranexamic acid (2 ampoules of kapron 500 mg) and (1 ampoule of dicynone) IV just before skin incision, Group B (Oxytocin group) received 30 IU of oxytocin in 500 ml normal saline will be administered during myomectomy, and Group C (Saline group) received 110 ml normal saline IV just before skin incision. This study was conducted in Sayed Galal Al-Azhar University Hospital and El-Galaa Teaching Hospital during period time from December 2018 to December 2019. Results: Using 1 g tranexamic acid and 1 ampoule of dicynone in abdominal myomectomy resulted in a significant reduction of blood loss than using 30 IU oxytocin in 500 ml normal saline immediately before the start of the surgery (509.24±57.28 ml in Tranexamic acid and ethamsylate group vs. 720.13±112.62 ml in oxytocin group). Conclusion: Tranexamic acid and ethamsylate are more effective in reducing the transfusion requirement than oxytocin with more stable hematological and hemodynamic profile.