Park Jong Taek, Choi Jae Chan, Lee Ji Yeon, Um Dea Ja
Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Korean J Anesthesiol. 2009 Oct;57(4):535-539. doi: 10.4097/kjae.2009.57.4.535.
Hysteroscopy is a procedure that may appear minimally invasive, but may result in potentially disastrous complications. A hysteroscopy requires the insertion of a hysteroscope into the uterine cavity and the installation of a suitable distention medium for the visualization of the endometrium. Fluid overload due to the absorption of distention media during hysteroscopy can cause mild to severe complications, including hyponatremia, hypoosmolarity, nausea, vomiting, headache, arrhythmia, blindness, confusion, seizure, cerebral edema, brain herniation, and death. We report a case of a 41 year-old female patient who underwent elective hysteroscopic myomectomy under general anesthesia. Approximately 4 hours after the beginning of the surgery, the patient's serum sodium concentration dropped to 109 mM. She was treated with furosemide and recovered without sequelae.
宫腔镜检查是一种看似微创的手术,但可能会导致潜在的灾难性并发症。宫腔镜检查需要将宫腔镜插入子宫腔,并注入合适的膨宫介质以观察子宫内膜。宫腔镜检查期间由于膨宫介质吸收导致的液体超负荷可引起轻至重度并发症,包括低钠血症、低渗透压、恶心、呕吐、头痛、心律失常、失明、意识模糊、癫痫发作、脑水肿、脑疝和死亡。我们报告一例41岁女性患者,她在全身麻醉下接受了择期宫腔镜子宫肌瘤切除术。手术开始约4小时后,患者血清钠浓度降至109 mM。她接受了呋塞米治疗,康复后无后遗症。