We have located links that may give you full text access.
Journal Article
Review
Hysteroscopy and anaesthesia.
Canadian Journal of Anaesthesia 1996 January
PURPOSE AND SOURCE: Hysteroscopy has become a widely accepted technique in the diagnosis and treatment of various gynaecological conditions. The advent of the fibreoptic endoscope and distending media has largely been responsible for the increasing use of hysteroscopy. It is our aim in this article to review the literature on the frequently used distending media such as carbon dioxide, glycine, dextran, dextrose, sorbitol and mannitol and their anaesthetic implications.
PRINCIPAL FINDINGS: The endoscopist chooses the particular medium. Complications due to the distending media occur in < 4% of cases. Dilutional hyponatraemia and hypothermia are commonly encountered complications and, in addition, hyperglycaemia and volume expansion can occur. Less commonly encountered complications are embolism with carbon dioxide and pulmonary oedema, renal failure and in rare cases anaphylaxis and encephalopathy. Regional anaesthesia may offer an advantage over general anaesthesia in early recognition of fluid accumulation. Apropriate monitoring should include fluid balance, routine monitoring as well as temperature, electrolytes and blood sugar measurements. Precordial Doppler measurement, central venous and/or pulmonary artery pressure measurement may be of help in detecting as well as treating carbon dioxide and/or air embolism and fluid balance in high risk patients.
CONCLUSIONS: There is no one commonly used medium and no one medium is devoid of complications. There have been no controlled studies comparing different anaesthetic techniques. Positioning of the patient can give rise to complications such as peripheral neuropathy. Hysteroscopy is a non invasive procedure which entails a short hospital course with minimal postoperative sequelae and may be cost saving.
PRINCIPAL FINDINGS: The endoscopist chooses the particular medium. Complications due to the distending media occur in < 4% of cases. Dilutional hyponatraemia and hypothermia are commonly encountered complications and, in addition, hyperglycaemia and volume expansion can occur. Less commonly encountered complications are embolism with carbon dioxide and pulmonary oedema, renal failure and in rare cases anaphylaxis and encephalopathy. Regional anaesthesia may offer an advantage over general anaesthesia in early recognition of fluid accumulation. Apropriate monitoring should include fluid balance, routine monitoring as well as temperature, electrolytes and blood sugar measurements. Precordial Doppler measurement, central venous and/or pulmonary artery pressure measurement may be of help in detecting as well as treating carbon dioxide and/or air embolism and fluid balance in high risk patients.
CONCLUSIONS: There is no one commonly used medium and no one medium is devoid of complications. There have been no controlled studies comparing different anaesthetic techniques. Positioning of the patient can give rise to complications such as peripheral neuropathy. Hysteroscopy is a non invasive procedure which entails a short hospital course with minimal postoperative sequelae and may be cost saving.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app