Bradycardia and Cardiac Arrest Caused by Intramyometrial Injection of Vasopressin During a Laparoscopically Assisted Myomectomy

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.