https://orcid.org/0000-0002-5896-9848
Abstract
Objective
The aim of this study was to determine if combining intravenous oxytocin infusion and spinal anesthesia will reduce the amount of glycine absorption in patients undergoing operative hysteroscopy.
Patients and Methods
A prospective controlled study was conducted in premenopausal patients who had hysteroscopic surgery including endometrial resection, endometrial polypectomy, myomectomy resection and uterine septal resection. The effect of combined spinal anesthetic with oxytocin infusion on fluid deficit was studied.
Results
A total of 88 patients were studied. Sixty-two cases were done under general anesthesia (control group) and 26 cases were performed with spinal anesthesia and the use of oxytocin infusion (study group). There was a statistically significant less mean fluid deficit in the study group than control group in the endometrial polypectomy patients (220±36 mL vs 392±178 mL, respectively, P value 0.010, 95% C.I.: 163–276) and the myomectomy patients (308±66 mL vs 564±371 mL, respectively, P value 0.003, 95% C.I.: 239–378). In the endometrial resections, there was also a statistically significant less mean fluid deficit in the study than the control group (P value ˂ 0.001). Regarding septal resection, there was no statistically significant difference in the mean fluid deficit between the two groups (P value 0.833).
Conclusion
Spinal anesthesia combined with intravenous oxytocin infusion in operative hysteroscopy results in a statistically significant reduction in the glycine fluid deficit than the general anesthesia. We also recommend studying the effects of this combination in operative hysteroscopy using bipolar devices with isotonic solutions.
Abbreviations
OHIA, operative hysteroscopy intravascular absorption; TURP, transurethral resection of prostate; GA, general anesthesia; U/S, ultra-sound; BMI, body mass index; BP, blood pressure; IU, international unit; ASA, American Society of Anesthesia; L, lumbar; mmHg, millimeter mercury; JUH, Jordan University Hospital; IRB, institutional review board; TCRE, trans-cervical resection of the endometrium; ET, endometrial thickness; MAP, mean arterial blood pressure; EBL, estimated blood loss; GnRH, gonadotrophin releasing hormone; PCNL, performing percutaneous nephrolithotomy.
Author Contributions
All authors contributed to data analysis, drafting or revising the article, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.