Pulmonary edema following intramyometrial injection and paracervical infiltration of vasopressin during laparoscopic myomectomy and LAVH (Laparoscopic abdominal vaginal hysterectomy): A report of 2 cases

Kim, Su Yeon; Lee, Jung Hyang; Bang, Eun Chi; Lee, Hyun Sook; Kang, Yong In; Cho, Kyung Sook; Kwon, Tae Hee

Case Report

Obstetric Anesthesia

Anesthesia and Pain Medicine 2010;5(4):333-337.
Published online October 31, 2010.

Pulmonary edema following intramyometrial injection and paracervical infiltration of vasopressin during laparoscopic myomectomy and LAVH (Laparoscopic abdominal vaginal hysterectomy): A report of 2 cases

Su Yeon Kim, Jung Hyang Lee, Eun Chi Bang, Hyun Sook Lee, Yong In Kang, Kyung Sook Cho, Tae Hee Kwon

¹Department of Anesthesia and Pain Medicine, CHA University, College of Medicine, Seoul, Korea. suykim3@chamc.co.kr
²Department of Radiology, CHA University, College of Medicine, Seoul, Korea

Abstract

Vasopressin is often used locally to reduce blood loss in gynecologic surgery. The use of local infiltration of low concentration vasopressin (0.05-0.3 units/ml) has been considered to be safe. However, serious side effects such as bradycardia, hypertension, arrhythmia, pulmonary edema, coronary vasospasm, myocardial infarction and even cardiac arrest were reported during low-dose vasopressin. In 2 healthy women with myoma and multiple myoma combined with adenomyosis, we experienced pulmonary edema after intramyometrial injection and paracervical infiltration of vasopressin. After diuretics and oxygen therapy, the patients were recovered without any complications.

Key Words: Intramyometrial injection, Paracervical infiltration, Pulmonary edema, Vasopressin