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 uterine fibroids, in comparison with a placebo-based patient control group. STUDY DESIGN: The study group (n=96, 53.3%) underwent an application of 12 mu g epinephrine hydrochloride 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 application 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 perioperative complications were observed in either group, and no statistically significant difference in the incidence of postoperative complications was recorded with our study group when compared to the control group (2.1% vs. 7.1%) (p=0.143). CONCLUSION: Epinephrine use during a laparoscopic myomectomy is both effective and safe.