Archives of Gynecology and Obstetrics

, Volume 298, Issue 5, pp 933–938 | Cite as

Hemodynamic effects of intramyometrial epinephrine injection for blood loss reduction in laparoscopic myomectomy

  • Jana NickolEmail author
  • Sebastian Berlit
  • Stefanie Lis
  • Amadeus Hornemann
  • Charalambos Tsagogiorgas
  • Marc Sütterlin
  • Benjamin Tuschy
General Gynecology



To evaluate changes in hemodynamic effects of intramyometrial epinephrine injection for blood loss reduction in laparoscopic myomectomy.


A total of 185 women with symptomatic uterine fibroids who underwent laparoscopic myomectomy were enrolled in this study. Eighty-six women (study collective) received an intramyometrial injection of epinephrine and were compared to ninety-nine women (control collective) who underwent laparoscopic myomectomy without an intramyometrial epinephrine injection. Demographic parameters, change of hemodynamic parameters during surgery as well as hemoglobin drop after surgery were analyzed.


In the study collective maximum systolic blood pressure (p < 0.001), maximum increase of the systolic blood pressure within 5 min (p = 0.003), duration of hypertension (p = 0.012), maximal (p < 0.001) and mean heart rate (p = 0.005), maximal increase of heart rate within 5 min (p = 0.003) and difference of mean to maximal heart rate (p < 0.001) were higher compared to the control collective. There was no difference in pre- and postoperative hemoglobin levels in both collectives and no intraoperative clinically relevant complication occurred due to intramyometrial epinephrine injection.


The intramyometrial application of epinephrine seems to be safe but leads to significant alterations of hemodynamic parameters without a significant change in postoperative hemoglobin levels.


Laparoscopic myomectomy Intramyometrial epinephrine Fibroid Hemodynamic effect 


Author contributions

JN: protocol development, manuscript writing. SB: manuscript editing. SL: data analysis. AH: data collection. CT: protocol development. MS: protocol development. BT: manuscript writing, protocol development.


There was no funding involved in the conduction of this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval was given by the Ethics Committee II at Heidelberg University, Heidelberg, Germany on 8 May 2018, reference number 2018-838R-MA.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, University Medical Centre MannheimHeidelberg UniversityMannheimGermany
  2. 2.Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty MannheimHeidelberg UniversityMannheimGermany
  3. 3.Department of Anesthesiology and Critical Care Medicine, University Medical Centre MannheimHeidelberg UniversityMannheimGermany

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