Evaluating efficacy of intravenous carbetocin in reducing blood loss during abdominal myomectomy: a randomized controlled trial

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Authors:

Ayman Taher, M.D., Dalia Farouk, M.D., Mohamed Mahmoud Mohamed Kotb, M.D., Nevein Kamal Ghamry, M.D., Khaled Kholaif, M.D., Ahmed A. Mageed A. Allah, M.D., Ahmed Said Ali, M.B.B.Ch., Omneya M. Osman, M.D., Hala Nabil, M.D., Yomna Islam, M.D., Mohamed Sobhy Bakry, M.D., Bassem Aly Islam, M.D., Mahmoud Alalfy, M.D., Salma Ashraf Nassar, M.D., Almandouh H. Bosilah, M.D., Ashraf A. Ghanem, M.D., Nansy Mohamed Ali Rund, M.D., Rania Refaat, M.D., Hamada Ashry Abdel Wahed Ali, M.D., Ahmed Bakry, M.D., Ahmed S.A. Ashour, M.D., Mohamed Nabil, M.D., Sherif Sameh Zaki, M.D.

Abstract:

Objective

To evaluate the efficacy of carbetocin versus placebo in decreasing intraoperative blood loss and the need for blood transfusion during abdominal myomectomy.


Design

Randomized, double-blind, placebo-controlled trial.


Setting

Tertiary university hospital from September 2019 to February 2020.


Patient(s)

A total of 138 women with symptomatic leiomyoma who were candidates for abdominal myomectomy (n = 69 in each group).


Intervention(s)

We randomized the study participants in a 1:1 ratio to carbetocin and placebo groups. Intravenous 100 μg carbetocin or placebo was administered slowly after induction of anesthesia.


Main Outcome Measure(s)

Intraoperative blood loss, need for blood transfusion, postoperative hemoglobin, operative time, length of hospitalization, and drug side-effects.


Result(s)

The baseline characteristics were similar among all groups. Carbetocin had significantly lower intraoperative blood loss compared with placebo (mean difference 184 mL). Hemoglobin level 24 hours after surgery was significantly lower in the placebo group than in the carbetocin group (9.1 ± 0.8 vs. 10.3 ± 0.6 g/dL). Eight women in the carbetocin group needed blood transfusion compared with 17 in placebo group. Operative time, length of hospitalization, and side-effects were similar in both groups.


Conclusion(s)

A single preoperative intravenous dose of 100 μg carbetocin is a simple, practical, and effective method of decreasing intraoperative blood loss and the need for blood transfusion during abdominal myomectomy, with tolerable, few, nonsignificant side-effects.


Clinical Trial Registration Number

NCT04083625

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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