Bradycardia and severe vasospasm caused by intramyometrial injection of vasopressin during myomectomy

Vasopressin is often used locally to reduce blood loss during surgery. Vasopressin has longest clinical effect, but its systemic effects may be profound and pose significant challenges for the anesthesiologist and it can also sometimes cause lethal complications. The loss of peripheral pulse along w...

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Bibliographic Details
Main Authors: Bina P Butala, Veena R Shah, Beena K Parikh, J Jayaprakash, Jasmita Kalo
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2014-01-01
Series:Saudi Journal of Anaesthesia
Subjects:
Online Access:http://www.saudija.org/article.asp?issn=1658-354X;year=2014;volume=8;issue=3;spage=396;epage=398;aulast=Butala
Description
Summary:Vasopressin is often used locally to reduce blood loss during surgery. Vasopressin has longest clinical effect, but its systemic effects may be profound and pose significant challenges for the anesthesiologist and it can also sometimes cause lethal complications. The loss of peripheral pulse along with bradycardia, non-measurable arterial blood pressure, and cardiac complications have been reported after myometrial injection of vasopressin. Here, we describe a patient with multiple uterine myomas who developed severe bradycardia, non-measurable blood pressure by non-invasive means and loss of peripheral pulse after myometrial injection of vasopressin at a total dose of 20 units (1 unit/ml) with documentation of severe peripheral arterial vasospasm and increased proximal blood pressure. The patient was successfully resuscitated.
ISSN:1658-354X