4.6 Article Proceedings Paper

Glycine absorption in operative hysteroscopy: the impact of anesthesia

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DOI: 10.1016/j.ajog.2008.12.024

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endometrial resection; general anesthesia; glycine absorption; local anesthesia and intravenous sedation; operative hysteroscopy

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OBJECTIVE: This study aimed to evaluate the impact of anesthesia on the absorption of glycine in operative hysteroscopy. STUDY DESIGN: A retrospective cohort study was performed over 2 years. The absorption of glycine was compared among general anesthesia, local anesthesia with intravenous sedation, and spinal anesthesia. Multiple logistic regression analyses were performed. RESULTS: In all, 282 operative hysteroscopies were reviewed. The median absorption was 145 mL (10th-90th centile: 0-963 mL) for general anesthesia, 35 mL (10th-90th centile: 0-389 mL) for local anesthesia, and 100 mL (10th-90th centile: 0-500 mL) for spinal anesthesia (P = .002). In comparison with general anesthesia, local anesthesia was associated with lower rate of absorption of 500-1000 mL (4.2% vs 13.4%) and of 1000-1500 mL (3.6% vs 9.8; P = .002). Laparoscopic tubal ligation performed during the procedure was also associated with higher glycine absorption (odds ratio, 3.63; 95% confidence interval, 1.12-11.84). CONCLUSIONS: Local anesthesia with sedation is associated with significantly decreased glycine absorption and lower rate of absorption > 500 mL when compared with general anesthesia.

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