Vasopressin as a Chemical Tourniquet During Vaginal Surgery

Abstract

We attempted to determine whether vasopressin injected during vaginal surgery decreases intraoperative blood loss without compromising intraoperative or postoperative results. To test this hypothesis, 35 women undergoing vaginal hysterectomy, with or without vaginal repair, were given intracervical (hysterectomy) or intravaginal (vaginal repair) vasopressin (10 units/30 ml normal saline). They were compared with 35 matched controls not receiving vasopressin as to blood loss during surgery, intraoperative clinical effects of vasopressin, postoperative infections, and incidence of delayed bleeding. A matched-pairs t-test was used for continuous variables, and Chi-square analysis was used for categorical variables. We found that the vasopressin group had significantly less intraoperative blood loss (296 ± 37 ml vs 435 ± 55 ml) (p < 0.02). Vasopressin significantly elevated both the mean systolic pressure (106 ± 2 mm Hg vs 114 ± 2 mm Hg) (p < 0.001) and diastolic blood pressure (67 ± 2 mm Hg vs 76 ± 2 mm Hg) (p < 0.001) but was not associated with adverse clinical effects. Postoperative infection was not statistically different in the vasopressin (0/35) and control groups (3/35) [X²(l) = 3.21] (0.05 < p < 0.10). Delayed hemorrhage in the vasopressin group (0/35) was significantly less than in the control group (4/35) [X²(l) = 4.52](p < 0.05). We conclude that vasopressin decreases intraoperative blood loss in vaginal surgery without complicating the intraoperative and postoperative outcome. It may not be a good choice in patients with hypertension, but we did not study enough patients with significant hypertension to draw such conclusions. (J GYNECOL SURG 9:161, 1993)