Prospective Study Investigating Change in Carboxyhemoglobin Blood Level During Operative Hysteroscopy.

Area of Science:

• Gynecologic Surgery
• Minimally Invasive Procedures
• Patient Safety

Background:

• Hysteroscopic resections using radiofrequency energy are common gynecologic procedures.
• Potential systemic absorption of byproducts, such as carbon monoxide, is a concern.

Purpose of the Study:

• To evaluate if radiofrequency energy use during resectoscopy increases patient blood carboxyhemoglobin (COHb) levels.
• To identify procedural variables linked to COHb elevations.

Main Methods:

• Prospective cross-sectional study of 40 subjects undergoing hysteroscopic procedures with bipolar radiofrequency energy.
• Blood COHb levels measured pre- and post-surgery; abnormal defined as ≥3.0% increase.
• Subjects with elevated COHb were screened for toxicity symptoms.

Main Results:

• 17.5% of subjects had abnormal postoperative COHb levels.
• Elevated COHb was associated with higher fluid deficit (p=0.024) and greater myoma volume (p=0.04).
• No subjects with elevated COHb reported toxicity symptoms; one had intraoperative hemodynamic changes.

Conclusions:

• Systemic carbon monoxide absorption is reproducible during hysteroscopic resections using bipolar diathermy.
• Absorption is linked to fluid deficit and myoma volume.
• Further research is needed on COHb safety in patients with comorbidities, considering potential long-term effects.