The Use of Glucose 5% as Irrigating Fluid During Hysteroscopy Reduces the Incidence of Hypontremic Encephalopathy. Double Blinded Randomized Study

Ayman Abd Al-maksoud Yousef

Abstract

Background: Excessive absorption of irrigating fluid during endoscopic surgical procedures produces central nervous system changes, circulatory disturbances and electrolyte imbalances. Wecompared glycine 1.5% versus glucose 5% as irrigating solutions in patients undergoing hysteroscopy for various diagnostic or therapeutic purposes. Patients and methods: One hundred patients were randomized into two equal groups according to the irrigation fluid used. Fifty patients used glycine 1.5% solution as irrigating fluid (glycine group) and 50 patients used glucose 5% solution (glucose group) as irrigating fluid during hysteroscopy.Patient’s demographics, operative time, postoperative amino acid glycine assay and peri-operative complications were observed. Results: No difference was found in the immediate pre-operative mean values of serum sodium, potassium, hemoglobin, and hematocrit in both groups. Elevated glycine levels were observed in 14 patients, hyponatremia developed in 11 patients, and encephalopathy developed in 6 patients in the glycine group.Patients in glucose group developed significant post-operative hyperglycemia, none of the patients developed manifest hyponatremia or encephalopathy. Conclusion: The use of glucose 5% solution as irrigating fluid during hysteroscopy produced transient postoperative decrease in serum sodium, potassium and significant hyperglycemia. None of the patients developed hyponatremic encephalopathy in glucose group.