Biochemical hemodynamic and hematological changes during transcervical resection of the endometrium using 1.5% glycine as the irrigating solution

Alka Kriplani, Jyoti Nath, D. Takkar, Maya Maya, H. L. Kaul
In: European Journal of Obstetrics & Gynecology and Reproductive Biology · 1998 · vol. 80(1) , pp. 99–104 · doi:10.1016/s0301-2115(98)00101-8 · PMID:9758269 · W2082748121
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This study investigated the biochemical, hemodynamic, and hematological effects of using 1.5% glycine as the irrigating solution during transcervical resection of the endometrium.

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Abstract

ObjectiveTo study fluid absorption during transcervical resection of the endometrium (TCRE) and its effect on the biochemical, hemodynamic and hematological alterations so that life threatening complications of fluid overload may be prevented.MethodIntraoperative fluid (1.5% glycine) absorption in 46 women undergoing TCRE was studied and correlated using biochemical parameters (serum sodium, potassium, total proteins, creatinine and blood urea), hemodynamic parameters (pulse rate, blood pressure, oxygen saturation and end tidal CO2) and hematological parameters. Twenty five of these patients had received danazol (800 mg/day) for six weeks prior to TCRE.ResultThe mean glycine deficit during TCRE was found to be 474.45 ml, with a mean total inflow of 3802.17 ml. Amongst all of the parameters, only serum sodium levels were found to be significantly inversely correlated with the glycine deficit. No case of hyponatremia occurred below a deficit of 1000 ml. Severe hyponatremia was reported in three cases (6.4%) and all three had a glycine deficit of more than 1000 ml. No case of pulmonary edema was noted. The mean glycine deficit was significantly lower (P=0.007) and the duration of procedure significantly shorter (P=0.0009) in the patients who had received danazol. None of the patients in the danazol group had fluid absorption of more than 1000 ml.ConclusionClose monitoring of fluid inflow and outflow should be done during TCRE. Above a deficit of 1000 ml, serum sodium should be measured to detect significant hyponatremia. The use of danazol for endometrial preparation also reduces the mean amount of fluid absorbed.

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