Bradycardia and cardiac arrest caused by intramyometrial injection of vasopressin during a laparoscopically assisted myomectomy

Obstet Gynecol. 2009 Feb;113(2 Pt 2):484-486. doi: 10.1097/AOG.0b013e318187e795.


Background: Vasopressin is often used locally to reduce blood loss during surgery. The use of a local infiltration of a low concentration of vasopressin, less than 0.05-0.3 units/mL, has been considered to be safe. The use of low-dose vasopressin is not free of side effects, and it can also sometimes cause lethal complications.

Case: In a healthy woman with multiple uterine myomas, we experienced a case of sudden cardiac arrest immediately after the intramyometrial injection of vasopressin at a total dose of 11 units (0.2 units/mL). The patient was successfully resuscitated.

Conclusion: Local intramyometrial infiltration of low-dose vasopressin may cause lethal cardiopulmonary complications.

Publication types

  • Case Reports

MeSH terms

  • Blood Loss, Surgical / prevention & control*
  • Bradycardia / chemically induced*
  • Dose-Response Relationship, Drug
  • Female
  • Heart Arrest / chemically induced*
  • Hemostatics / administration & dosage
  • Hemostatics / adverse effects*
  • Humans
  • Injections, Intramuscular / adverse effects
  • Injections, Intramuscular / methods
  • Laparoscopy
  • Leiomyomatosis / surgery
  • Vasopressins / administration & dosage
  • Vasopressins / adverse effects*


  • Hemostatics
  • Vasopressins