Effectiveness of tourniquet with and without adjunctive misoprostol on haemorrhage during open myomectomy: A randomised controlled trial.

Reducing intraoperative haemorrhage during open abdominal myomectomy is essential, as excessive bleeding is a major complication. This double-blind, randomised controlled trial, conducted at two tertiary hospitals in Nigeria between July 2020 and January 2021, compared the effect of combining misoprostol with a tourniquet versus a tourniquet alone on intraoperative blood loss. One hundred and forty consenting women were randomised in equal numbers to the intervention (tourniquet plus misoprostol) or the control (tourniquet only) group. The primary outcome was intraoperative blood loss, while secondary outcomes included duration of surgery, blood transfusion requirements, and adverse effects. Mean blood loss was significantly lower in the intervention group (678.2±42.4 ml) than in the control group (837.0±39.2 ml; P=0.042). There were no significant differences in transfusion rates, operative duration, or side effects between groups. The addition of misoprostol to a pericervical tourniquet effectively reduces intraoperative blood loss without increasing adverse events in women undergoing open abdominal myomectomy.