The use of inhaled sevoflurane during operative hysteroscopy is associated with increased glycine absorption compared to intravenous propofol for maintenance of anesthesia

Munmany, Meritxell; Gràcia, Meritxell; Nonell, Roser; Cardona, Montserrat; Pons, Martí; Martin, Miriam; Alcolea, Antonia; Balasch, Juan; Carmona, Francisco

doi:10.1016/j.jclinane.2016.02.012

Cited by 9 publications

(9 citation statements)

References 21 publications

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“…Therefore, sufficient depth of anesthesia and analgesic intensity is required. Admittedly, intraspinal anesthesia can provide adequate analgesia and satisfactory patient cooperation, but it is not conducive to rapid postoperative recovery of patients [14]. With the application of propofol and remifentanil in clinical practice, short IV anesthesia is possible and can be easily accepted by surgeons and patients.…”

Section: Discussionmentioning

confidence: 99%

Supraglottic jet oxygenation and ventilation for obese patients under intravenous anesthesia during hysteroscopy: a randomized controlled clinical trial

et al. 2019

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Background Supraglottic jet oxygenation and ventilation (SJOV) can effectively maintain adequate oxygenation in patients with respiratory depression, even in apnea patients. However, there have been no randomized controlled clinical trials of SJOV in obese patients. This study investigated the efficacy and safety of SJOV using WEI Nasal Jet tube (WNJ) for obese patients who underwent hysteroscopy under intravenous anesthesia without endotracheal intubation. Methods A single-center, prospective, randomized controlled study was conducted. The obese patients receiving hysteroscopy under intravenous anesthesia were randomly divided into three groups: Control group maintaining oxygen supply via face masks (100% oxygen, flow at 6 L/min), the WNJ Oxygen Group with WNJ (100% oxygen, flow: 6 L/min) and the WNJ SJOV Group with SJOV via WNJ [Jet ventilator working parameters:100% oxygen supply, driving pressure (DP) 0.1 MPa, respiratory rate; (RR): 15 bpm, I/E; ratio 1:1.5]. SpO 2 , P ET CO 2 , BP, HR, ECG and BIS were continuously monitored during anesthesia. Two-Diameter Method was deployed to measure cross sectional area of the gastric antrum (CSA-GA) by ultrasound before and after SJOV in the WNJ SJOV Group. Episodes of SpO 2 less than 95%, P ET CO 2 less than 10 mmHg, depth of WNJ placement and measured CSA-GA before and after jet ventilation in the WNJ SJOV Group during the operation were recorded. The other adverse events were collected as well. Results A total of 102 patients were enrolled, with two patients excluded. Demographic characteristics were similar among the three groups. Compared with the Control Group, the incidence of P ET CO 2 < 10 mmHg, SpO 2 < 95% in the WNJ SJOV group dropped from 36 to 9% ( P = 0.009),from 33 to 6% ( P = 0.006) respectively,and the application rate of jaw-lift decreased from 33 to 3% ( P = 0.001), and the total percentage of adverse events decreased from 36 to 12% ( P = 0.004). Compared with the WNJ Oxygen Group, the use of SJOV via WNJ significantly decreased episodes of SpO 2 < 95% from 27 to 6% ( P = 0.023), P ET CO 2 < 10 mmHg from 33 to 9% ( P = 0.017), respectively. Depth of WNJ placement was about 12.34 cm in WNJ SJOV Group. There was no significantly difference of CSA-GA before and after SJOV in the WNJ SJOV Group ( P = 0.234). There were no obvious cases of nasal bleeding in all the three groups. Conclusions SJOV can effectively and safely maintain adequate oxygenati...

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Section: Discussionmentioning

confidence: 99%

Supraglottic jet oxygenation and ventilation for obese patients under intravenous anesthesia during hysteroscopy: a randomized controlled clinical trial

et al. 2019

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“…Use of sevoflurane was associated with significantly more glycine absorption than propofol. 27 Our results were further enhanced by the use of spinal anesthesia. This was supported by the findings of Moharram et al 28 that spinal anesthesia was associated with less glycine absorption.…”

Section: Discussionmentioning

confidence: 63%

<p>The Impact of Spinal Anesthesia and Use of Oxytocin on Fluid Absorption in Patients Undergoing Operative Hysteroscopy: Results from a Prospective Controlled Study</p>

Al-Husban¹,

Aloweidi²,

Ababneh³

2020

IJWH

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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.

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“…35 Lastly, a study by Munmany et al published in 2016 compared propofol infusion with inhaled sevoflurane at the time of operative hysteroscopy and noted a significantly lower deficit for the group receiving propofol (median deficit 202 mL, range 60-542 mL vs median deficit 264, range 153-932, P5.007). 33 Shokeir et al compared oxytocin infusion at a rate of 400 milliunits/min with a control group at the time of endometrial resection and found reduced mean fluid absorption in the intervention group (490.3 mL vs 660.0 mL, P5004). Total fluid use, operative time, and complications were otherwise similar.…”

Section: Resultsmentioning

confidence: 99%

Pharmacologic Interventions to Minimize Fluid Absorption at the Time of Hysteroscopy

Desilets

Zakhari

Chagnon

et al. 2023

Obstetrics &Amp; Gynecology

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The use of inhaled sevoflurane during operative hysteroscopy is associated with increased glycine absorption compared to intravenous propofol for maintenance of anesthesia

Cited by 9 publications

References 21 publications

Supraglottic jet oxygenation and ventilation for obese patients under intravenous anesthesia during hysteroscopy: a randomized controlled clinical trial

Supraglottic jet oxygenation and ventilation for obese patients under intravenous anesthesia during hysteroscopy: a randomized controlled clinical trial

<p>The Impact of Spinal Anesthesia and Use of Oxytocin on Fluid Absorption in Patients Undergoing Operative Hysteroscopy: Results from a Prospective Controlled Study</p>

Pharmacologic Interventions to Minimize Fluid Absorption at the Time of Hysteroscopy

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