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The course of anesthesia during uterine extirpation for large and giant myomas depends on the efficiency of blood loss compensation and relative hypovolemia after rapid decompensation when a mass is removed. Thirty-five patients with a uterine myoma with the size corresponding to 18-40-week gestation were examined. Dextrans and voluven (hydroxyethylstarch 130/0.4) were used in Groups 1 (n = 20) and 2 (n = 15). The intraoperative administration of voluven reduced the volume of crystalloids and a need for sympathomimetics and maintained the normal amount of fluid and sectoral distribution.

To develop a quantitative method of evaluation of the volume and degree of intraoperative blood loss.Blood loss quantitation is based on maximal collection of the lost blood and its measurement by lost globular volume (GV), i.e. erythrocyte containing medium with Ht 1.0.The total of the components of lost GV was termed estimated blood loss (EBL). Its amount was calculated by GV deficiency from the due in the patient and volume of lost blood. The method was tried in surgical and traumatological practice in 317 operated patients (multitrauma--65, hip bone fractures -98, uterine myoma -105, aneurysm of abdominal aortic part -49).The volume of blood loss guided the physician to reestablish volume of circulating blood--the volume of infused blood exceeded EBL 1.3-1.7-fold. GV deficiency (in %) showed severity of blood loss and gave approaches to its adequate compensation.