Systemic absorption of glycine irrigation solution during endometrial ablation by transcervical endometrial resection.

Abstract

OBJECTIVE: To study systemic absorption of glycine irrigation solution and its consequences during transcervical endometrial resection (TCER). DESIGN, SETTING, PATIENTS: A prospective study of 20 consecutive female patients who underwent elective TCER in a teaching hospital. METHOD: During the operation, patients were monitored with electrocardiography, automated oscillotonometry, pulse oximetry, capnography and a central venous pressure recorder. Plasma sodium and potassium levels were measured at 15-minute intervals. Blood haemoglobin concentration, serum osmolality, and plasma sodium, potassium and glycine concentrations were measured before and after surgery. RESULTS: Plasma glycine concentration increased in all patients after TCER. The highest concentration recorded was 5575 mumol/L. The increase correlated only with the maximum intraoperative decrease in plasma sodium, which was 7 mmol/L in two patients whose plasma glycine level increased by 3001 mumol/L and 5335 mumol/L. CONCLUSION: Systemic absorption of glycine irrigation solution occurred in all patients during TCER. Serial measurement of plasma sodium was necessary to detect this complication. A decrease in plasma sodium level by 7 mmol/L or more during surgery would indicate fluid absorption that could cause severe hyperglycinaemia and other potential complications.