Objectives: The management of anesthesia for patients with large myomas is particularly important due to disruption of hemodynamic as a result of massive hemorrhage, the prolonged duration of surgery and requirement for additional interventions. This study evaluated the effect of anesthetic technique on blood loss in patients undergoing myomectomy due to large fibroid uterus. 

Material and methods: A total of 156 patients that underwent myomectomy were randomized into two equal groups according to the type of anesthesia: Epidural anesthesia group and General anesthesia group. The volume of blood loss and blood products transfusion was reviewed for each patient. 

Results: The intraoperative blood loss and need for blood transfusion were significantly higher in general anesthesia group (p < 0.001). The mean hematocrit change was 2.5 ± 1.5 vs 3.7 ± 2.9% (p = 0.001) for both groups.

Conclusions: In the myomectomy planning of women with a large fibroid uterus, the team of gynecologists and anesthesiologists should take care to choose the most optimal technique for anesthesia.

MOHAMED M. A. FARGHALI M.D., Professor of obstetrics and Gynecology, Ain Shams University, Egypt. Consultant of Obstetrics and Gynecology, Maternity Sabah Hospital, Kuwait. Professor FARGHALI has completed his M.D. at the age of 33 years from Ain Shams University , Egypt. He has over 30 publications that have been cited over 150 times. He has been serving as an editorial board member of several reputed journals. Editorial Board Member of BMC Women's Health journal. Associate Editor of Frontiers Reproductive Health journal.