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

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.