Does Neuromuscular Blockade Affect the Assessment of Pelvic Organ Prolapse?

Brazell, Hema D.; Claydon, C Sage; Li, Janet; Moore, Carol; Dereska, Nina H; Hudson, Suzanne; Swift, Steven

doi:10.1097/ogx.0b013e318285bc1f

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2017

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“…During anesthesia, the patient's levator ani muscles become relaxed, which might contribute to the increased degree of descent measured with traction under anesthesia. This has been demonstrated previously, when assessment in the theater showed significantly greater POP‐Q examination measurements compared with the clinic ones . In another study, a significant intraoperative increase in measurements was demonstrated only in the case of grade 1 apical prolapse; the authors attributed this to relaxation of the tissues under general anesthesia.…”

Section: Discussionsupporting

confidence: 54%

Comparison between the Valsalva maneuver and intraoperative traction measurements in pelvic organ prolapse assessment

Doumouchtsis

Gauthaman

Khunda

et al. 2017

Intl J Gynecology & Obste

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Measurements of six POP-Q points obtained with traction showed a higher grade of POP than those assessed with Valsalva maneuver. On this basis, surgeons might decide on the extent of surgical procedure after examination under anesthesia; however, preoperative patient counselling would be essential to obtain consent for this approach. The clinical significance of the findings requires further evaluation.

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Section: Discussionsupporting

confidence: 54%