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Myomectomy

Anesthesia Implications
Position : Supine, Lithotomy, arms tucked
Time : 1-2 hours (average)
Blood Loss : High (200 - 500 ml)

Anesthetic Approaches

1GETT
The Anesthesia:

Have Atropine and/or Robinul available for vagal response to uterine manipulation by the surgeon. If you have a vagal response (reduced heart rate with possible reduction in blood pressure) 1. inform the surgeon so they can quit whatever it is they are doing 2. Simultaneously prepare Atropine/Robinul and administer if the problem persists.

The Surgery:

Surgical procedure to remove uterine fibroids. Most often done laparoscopically. The fibroids are excised and drawn out either through the laparoscopic holes or through an incision made in the vagina. Care will be taken to suture and repair the uterus to prevent ongoing complications.


Reference

Oxford Medical Publications. Oxford handbook of anesthesia. 4th edition. 2016.
Jaffe. Anesthesiologist’s manual of surgical procedures. 15th edition. 2014.