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Zullo, F., Palomba, S., Corea, D., Pellicano, M., Russo, T., Falbo, A., Barletta, E., Saraco, P., Doldo, P. and Zupi, E. (2004) Bupivacaine plus epinephrine for laparoscopic myomectomy: A randomized placebo-controlled trial. Obstetrics & Gynecology, 104, 243-249. http://dx.doi.org/10.1097/01.AOG. 0000132801.41880.e8

has been cited by the following article:

• TITLE: Laparoscopic-assisted instillation of epinephrine and levobupivacaine enables cornual excision and anatomical reconstruction in unruptured cornual pregnancy

  AUTHORS: Juan Gilabert-Estelles, Juan Gilabert-Aguilar

  KEYWORDS: Cornual Pregnancy; Levobupivacaine; Epinephrine; Laparoscopy; Vasoconstrictive Agents

  JOURNAL NAME: Open Journal of Obstetrics and Gynecology, Vol.4 No.2, February 11, 2014

  ABSTRACT: The objective of this report is to describe the possible use of intramiometrial vasoconstrictive agents for laparoscopic management of interstitial pregnancy and the consequences in anatomical results and reproductive outcomes. Cornual resection can be performed by laparoscopy, but the high vascularization of this area may result in profuse bleeding and laparoscopic suturing under these conditions might be impossible for the majority of the surgeons. We present a case that describes the possible use of intramiometrial instillation of a solution of diluted epinephrine and levobupivacaine under laparoscopic guidance that permitted a bloodless cornual excision with complete reconstruction. Vasoactive agents might have potentially serious cardiovascular side effects and the correct election of the active principle and the dosage is essential to reduce the risk of the surgery and obtain good anatomical results and reproductive outcomes. In conclusion, unruptured interstitial pregnancies can be managed successfully with intramyometrial instillation of epinephrine and bupivacaine. This simple technique is particularly attractive as it facilitates anatomical reconstruction of the cornual area, gives enough time to perform a complete suture of the defect and reduces the risk of laparotomic conversion.