Hematological, Biochemical and Hemodynamic Changes during Operative Hysteroscopy using Consecutive Distension Media

ABSTRACTBackground Hysteroscopy is a procedure for management of intrauterine pathology. Glycine 1.5% (200 mOsm/L) is one of the most commonly used distension media in hysteroscopy; but it carries risk of hypervolemia and dilutional hyponatremia.Objectives Studying effects of systemic absorption of...

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Main Authors: Ahmed Mohamed Mandour, Abdelraheem Elawamy, Abdelraouf M.S Abdelraouf, Ahmed Mohamed Elsonbaty, Mostafa Elsonbaty, Atef M Darwish, Esam Abdalla, Zein . Z Hassan, Mohamed Anwar
Format: Article
Language:English
Published: Taylor & Francis Group 2023-12-01
Series:Egyptian Journal of Anaesthesia
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/11101849.2023.2174832
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author Ahmed Mohamed Mandour
Abdelraheem Elawamy
Abdelraouf M.S Abdelraouf
Ahmed Mohamed Elsonbaty
Mostafa Elsonbaty
Atef M Darwish
Esam Abdalla
Zein . Z Hassan
Mohamed Anwar
author_facet Ahmed Mohamed Mandour
Abdelraheem Elawamy
Abdelraouf M.S Abdelraouf
Ahmed Mohamed Elsonbaty
Mostafa Elsonbaty
Atef M Darwish
Esam Abdalla
Zein . Z Hassan
Mohamed Anwar
author_sort Ahmed Mohamed Mandour
collection DOAJ
description ABSTRACTBackground Hysteroscopy is a procedure for management of intrauterine pathology. Glycine 1.5% (200 mOsm/L) is one of the most commonly used distension media in hysteroscopy; but it carries risk of hypervolemia and dilutional hyponatremia.Objectives Studying effects of systemic absorption of irrigating fluids on hemodynamic parameters, detect fluid deficit impact on clinical outcome included biochemical, hematological parameters, conscious level, pulmonary congestion and/or edema postoperative bleeding and hospital stay.Methods Sixty patients ASA classes I & II aged between 20 and 40 years underwent elective operative hysteroscopy randomly assigned into two groups. The Study group (30 patients): where consequent saline 0.9% and glycine 1.5% were used as irrigating distension media. Control group (30 patients): where glycine 1.5% alone was used as a distension medium.Results Comparing study and control group regarding (MBP) and heart rate, they were significantly higher at recovery and 6 hours postoperatively in the control group. (CVP) readings, showed significantly higher reading in the control group at times (15 m, 30 m, 45 m after induction, six hours and after recovery). Thoracic electrical bioimpedance parameters showed that COP, Cardiac index, Stroke volume and Stroke index were significantly higher in the control group than study group at 6 hours postoperatively. Regarding serum sodium, it was significantly lower in the control group than study group at times (15 min, 30 min and 45 min intra operatively) compared to pre-induction value. Serum osmolality was lower at 6 hours in the control group. Hemoglobin, hematocrit and platelet count was lower at 6 hours among control group.Conclusion The sequential use of saline 0.9% and glycine 1.5% decreased the amount of absorbed glycine 1.5% and hence the related side effects and complications.Trial registration Clinical Trials.gov. (NCT03166228)
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spelling doaj.art-33348c7388624059be3119bc06b8f3f22023-02-05T05:38:16ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492023-12-0139113414010.1080/11101849.2023.2174832Hematological, Biochemical and Hemodynamic Changes during Operative Hysteroscopy using Consecutive Distension MediaAhmed Mohamed Mandour0Abdelraheem Elawamy1Abdelraouf M.S Abdelraouf2Ahmed Mohamed Elsonbaty3Mostafa Elsonbaty4Atef M Darwish5Esam Abdalla6Zein . Z Hassan7Mohamed Anwar8Anesthesia & ICU Department, Faculty of Medicine, Assiut University, Asyut, EgyptAnesthesia & ICU Department, Faculty of Medicine, Assiut University, Asyut, EgyptAnesthesia & ICU Department, Faculty of Medicine, Assiut University, Asyut, EgyptAnesthesia & ICU Department, Faculty of Medicine, Assiut University, Asyut, EgyptWoman’s Health Hospital,Faculty of Medicine, Assiut University, Asyut, EgyptWoman’s Health Hospital,Faculty of Medicine, Assiut University, Asyut, EgyptAnesthesia & ICU Department, Faculty of Medicine, Assiut University, Asyut, EgyptAnesthesia & ICU Department, Faculty of Medicine, Assiut University, Asyut, EgyptAnesthesia & ICU Department, Faculty of Medicine, Assiut University, Asyut, EgyptABSTRACTBackground Hysteroscopy is a procedure for management of intrauterine pathology. Glycine 1.5% (200 mOsm/L) is one of the most commonly used distension media in hysteroscopy; but it carries risk of hypervolemia and dilutional hyponatremia.Objectives Studying effects of systemic absorption of irrigating fluids on hemodynamic parameters, detect fluid deficit impact on clinical outcome included biochemical, hematological parameters, conscious level, pulmonary congestion and/or edema postoperative bleeding and hospital stay.Methods Sixty patients ASA classes I & II aged between 20 and 40 years underwent elective operative hysteroscopy randomly assigned into two groups. The Study group (30 patients): where consequent saline 0.9% and glycine 1.5% were used as irrigating distension media. Control group (30 patients): where glycine 1.5% alone was used as a distension medium.Results Comparing study and control group regarding (MBP) and heart rate, they were significantly higher at recovery and 6 hours postoperatively in the control group. (CVP) readings, showed significantly higher reading in the control group at times (15 m, 30 m, 45 m after induction, six hours and after recovery). Thoracic electrical bioimpedance parameters showed that COP, Cardiac index, Stroke volume and Stroke index were significantly higher in the control group than study group at 6 hours postoperatively. Regarding serum sodium, it was significantly lower in the control group than study group at times (15 min, 30 min and 45 min intra operatively) compared to pre-induction value. Serum osmolality was lower at 6 hours in the control group. Hemoglobin, hematocrit and platelet count was lower at 6 hours among control group.Conclusion The sequential use of saline 0.9% and glycine 1.5% decreased the amount of absorbed glycine 1.5% and hence the related side effects and complications.Trial registration Clinical Trials.gov. (NCT03166228)https://www.tandfonline.com/doi/10.1080/11101849.2023.2174832Hysteroscopyglycine 1.5%saline 0.9%hemodynamic changeshematological changesbiochemical changes
spellingShingle Ahmed Mohamed Mandour
Abdelraheem Elawamy
Abdelraouf M.S Abdelraouf
Ahmed Mohamed Elsonbaty
Mostafa Elsonbaty
Atef M Darwish
Esam Abdalla
Zein . Z Hassan
Mohamed Anwar
Hematological, Biochemical and Hemodynamic Changes during Operative Hysteroscopy using Consecutive Distension Media
Egyptian Journal of Anaesthesia
Hysteroscopy
glycine 1.5%
saline 0.9%
hemodynamic changes
hematological changes
biochemical changes
title Hematological, Biochemical and Hemodynamic Changes during Operative Hysteroscopy using Consecutive Distension Media
title_full Hematological, Biochemical and Hemodynamic Changes during Operative Hysteroscopy using Consecutive Distension Media
title_fullStr Hematological, Biochemical and Hemodynamic Changes during Operative Hysteroscopy using Consecutive Distension Media
title_full_unstemmed Hematological, Biochemical and Hemodynamic Changes during Operative Hysteroscopy using Consecutive Distension Media
title_short Hematological, Biochemical and Hemodynamic Changes during Operative Hysteroscopy using Consecutive Distension Media
title_sort hematological biochemical and hemodynamic changes during operative hysteroscopy using consecutive distension media
topic Hysteroscopy
glycine 1.5%
saline 0.9%
hemodynamic changes
hematological changes
biochemical changes
url https://www.tandfonline.com/doi/10.1080/11101849.2023.2174832
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