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Transcervical endometrial resection syndrome
M McSwiney1, J Myatt, M Hargreaves
1Shackleton Department of Anaesthesia, Southampton General Hospital.
Anaesthesia
|March 1, 1995
Summary
Trans-cervical endometrial resection using 1.5% glycine solution can lead to fluid shifts. Monitoring plasma sodium is crucial as hyponatremia is a risk during this gynecological procedure.
Area of Science:
- Gynecology
- Surgical Procedures
- Fluid and Electrolyte Balance
Background:
- Trans-cervical endometrial resection involves irrigating the uterine cavity under pressure.
- 1.5% glycine solution is commonly used for uterine distension during the procedure.
- Potential for systemic absorption of irrigation fluid exists, leading to physiological changes.
Observation:
- Plasma sodium concentration was analyzed in 21 women undergoing the procedure.
- A decrease in plasma sodium was observed in all participants.
- Five patients experienced a significant drop in plasma sodium (> 10 mmol.l-1).
Findings:
- The use of 1.5% glycine solution during transcervical endometrial resection consistently lowers plasma sodium levels.
- A notable decrease in plasma sodium concentration is a common outcome.
- Significant hyponatremia can occur in a subset of patients.
Implications:
- Hyponatremia represents a significant risk associated with transcervical endometrial resection.
- Close monitoring of fluid and electrolyte balance, particularly sodium levels, is essential post-procedure.
- Clinical vigilance is required to manage potential complications arising from glycine absorption.