school is in session - OMG this answer is so scarey Posted: Mar 30th, 2017 - 4:20 pm In Reply to: Tumescent solutions - are used in surgery
Here is the original post:
"A total of of 16 mL of s/l Puchessant solution in a 1:5 dilution was used total during our operating time to remove the fibroid and sequential pieces."
The key to knowing a vasopressin was used in this example - and not tumescent fluid - is 16 mL of (sic) pitessin solution in a 1 to 5 dilution.
If you read through the excerpts below, this correlates perfectly to the statement that:
a. Use vasopressin in a diluted condition, and,
b. Do not use more than 50 mL.
Additionally, if you google tumescent solution for myomectomy, you will only get results for using tumescent solution in liposuction procedures, no results for using in a myomectomy procedure.
If you can find documentation to the contrary of these statements, I would be glad to read about it.
From OBG Management 2010, March22(3)
(see link)
"Vasopressin is a uterotonic in the nonpregnant uterus
The fraternal twins oxytocin and vasopressin are both secreted from the posterior pituitary gland. Both are nanopeptides that differ only in two amino acids.
Oxytocin binds to a myometrial cell-surface oxytocin receptor, thus increasing concentrations of intracellular cyclic adenosine monophosphate (cAMP), resulting in uterine contractions.
Vasopressin regulates plasma volume, blood pressure, and osmolality. It causes vasoconstriction by acting through the vasopressin (V1) receptor and exerts its antidiuretic action through the V2 receptor in the kidney. The major mechanism by which vasopressin reduces blood loss is vasoconstriction.
Vasopressin also stimulates uterine contractions by acting through myometrial V1a receptors. Unlike oxytocin receptors, which are plentiful in the term uterus but far less abundant in the nonpregnant uterus, vasopressin receptors are present in the myometrium of both pregnant and nonpregnant women.1
Administering vasopressin to nonpregnant women can therefore induce uterine contractions and the symptom of dysmenorrhea. A vasopressin antagonist will attenuate those effects.2 "
" What is an optimal dose and dilution?
Sparse high-quality data guide the selection of an optimal dosage and dilution of vasopressin. But, as with most pharmacotherapeutic agents that produce adverse effects at a high dosage, it is often wise to use the lowest that is efficacious.11 The clinical literature suggests several guidelines that may help reduce the likelihood and severity of adverse effects of vasopressin."
"Dilute the vasopressin in the range of 0.1 to 0.2 U/mL. Avoid concentrations >1 U/mL."
" Dosage
Don’t exceed a total dosage of approximately 5 units. Using a solution of 0.1 U/mL, the maximum injection is 50 mL. "
LINK/URL: school is in session
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