Keywords
Blood Loss
Hydrodissection
Saline
Vaginal Hysterectomy
How to Cite
Abstract
Background: The reduction of intraoperative blood loss during vaginal hysterectomy is crucial for minimizing surgical complications and improving operative conditions. Hydrodissection is commonly used to facilitate tissue separation, and the addition of adrenaline to saline has been suggested to further reduce bleeding through vasoconstriction.
Objectives: To compare mean intraoperative blood loss between patients undergoing vaginal hysterectomy with hydrodissection using saline alone versus saline combined with adrenaline.
Study Design & Setting: A comparative cross-sectional study conducted in the Department of Obstetrics and Gynecology Mekran Medical College (MMC), Turbat.
Methodology: A total of 114 patients scheduled for elective vaginal hysterectomy were enrolled and divided equally into two groups (57 patients each). Group A received hydrodissection with normal saline, while Group B received hydrodissection with saline combined with adrenaline (1:200,000). Standardized surgical techniques were followed for all procedures. Intraoperative blood loss was measured using the volume in suction apparatus and the weight of surgical sponges. Demographic and operative data were recorded and analyzed using SPSS version 20. Numerical data were expressed as mean ± SD, and the independent sample t-test was applied for comparison. A p-value ≤0.05 was considered statistically significant.
Results: The baseline characteristics of patients undergoing vaginal hysterectomy were comparable between the two study groups. The mean age in the saline hydrodissection group was 49.3 ± 6.8 years, while it was 48.7 ± 7.1 years in the saline–adrenaline hydrodissection group. Mean intraoperative blood loss was significantly higher in the saline group (92.4 ± 13.8 mL) compared to the saline–adrenaline group (85.1 ± 14.2 mL), with a p-value of 0.005. Intraoperative characteristics showed comparable surgical conditions in both groups. The mean duration of surgery was 72.4 ± 11.6 minutes in patients receiving saline hydrodissection and 69.8 ± 10.9 minutes in those receiving saline–adrenaline hydrodissection.
Conclusion: Hydrodissection with saline–adrenaline significantly reduces intraoperative blood loss compared to saline alone during vaginal hysterectomy and may improve surgical conditions.