Transient blood oxygen desaturation, hypercapnia, and coagulopathy after operative hysteroscopy with glycine used as the distending medium

Abstract

Objective: Our purpose was to report transient complications associated with operative hysteroscopy with glycine used as the distending medium. Objective: All the operative hysteroscopies performed over a 6-month period by a single operator were examined. The blood oxygenation and end-tidal carbon dioxide concentrations were monitored in all cases with a pulse oximeter and a capnograph. Blood samples were obtained during the operation and over the next day to determine coagulation functions, sodium levels, and a complete blood cell count. Results: Oxygen desaturation accompanied by a simultaneous increase in blood carbon dioxide levels occurred in six of the 46 patients. In addition, four of these patients were found to have a significant blood coagulopathy. Hyponatremia was observed in only two of the latter patients. Conclusion: Patients undergoing transcervical resection of the endometrium or submucous myomectomy must be closely monitored because disturbances in oxygenation and coagulation functions are not rare. The possibility of avoiding these complications by careful control of intrauterine pressure and the absorption of glycine should be further examined. Objective: Our purpose was to report transient complications associated with operative hysteroscopy with glycine used as the distending medium. Objective: All the operative hysteroscopies performed over a 6-month period by a single operator were examined. The blood oxygenation and end-tidal carbon dioxide concentrations were monitored in all cases with a pulse oximeter and a capnograph. Blood samples were obtained during the operation and over the next day to determine coagulation functions, sodium levels, and a complete blood cell count. Results: Oxygen desaturation accompanied by a simultaneous increase in blood carbon dioxide levels occurred in six of the 46 patients. In addition, four of these patients were found to have a significant blood coagulopathy. Hyponatremia was observed in only two of the latter patients. Conclusion: Patients undergoing transcervical resection of the endometrium or submucous myomectomy must be closely monitored because disturbances in oxygenation and coagulation functions are not rare. The possibility of avoiding these complications by careful control of intrauterine pressure and the absorption of glycine should be further examined.