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The impact of anesthesia on hemodynamic and volume changes in operative hysteroscopy: a bioimpedance randomized study
Ehab E Moharram1, Ahmed M El Attar2, Moustafa A Kamel2
1Medical Research Institute, Alexandria University.
Background:
Operative hysteroscopy is accompanied by the use of distention medium. Its absorption can lead to volume overload and hemodynamic disturbances that can lead to serious complications. We investigated the impact of the type of anesthesia on decreasing these complications with the use of noninvasive thoracic bioimpedance.
Design:
A prospective, randomized, blind study.
Method:
Sixty women, with American Society of Anesthesiologists classifications I-III, undergoing operative hysteroscopy were randomly allocated into 2 groups. Spinal anesthesia group received intrathecal 0.5% hyperbaric bupivacaine 12.5 mg and 25 μg fentanyl; the other group received general anesthesia with intravenous analgesia, propofol, and rocuronium followed by endotracheal intubation. Total glycine absorption, cardiac output, systemic vascular resistance, thoracic fluid content (noninvasive thoracic bioimpedance), and serum sodium were measured.
Results:
Women in the general anesthesia group showed more significant changes in the total glycine absorption, thoracic fluid content, and hemodynamic parameters. Serum sodium decreased significantly postoperatively in the general anesthesia group.
Conclusion:
Spinal anesthesia is associated with less glycine absorption, less thoracic fluid load, better control of hemodynamics, and better patient satisfaction in operative hysteroscopy.