Low-Dose Spinal Anesthesia with Hyperbaric Bupivacaine with Intrathecal Fentanyl for Operative Hysteroscopy: A Case Series Study

Florio, Pasquale; Puzzutiello, Rosa; Filippeschi, Marco; D’Onofrio, Pasquale; Mereu, Liliana; Morelli, Rosita; Marianello, Daniele; Litta, Pietro; Mencaglia, Luca

doi:10.1016/j.jmig.2011.08.728

Cited by 22 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although regional anesthesia is infrequently used for hysteroscopic procedures, a recent case series supports the use of low-dose spinal anesthesia as a feasible technique for operative hysteroscopy in women with high surgical risks. 13 The reader is referred to the recent American College of Obstetricians and Gynecologists guidelines on the subject. 14 …”

Section: Regional and General Anesthesiamentioning

confidence: 99%

Complications of Hysteroscopic and Uterine Resectoscopic Surgery

Munro

Christianson

2015

Clinical Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

Adverse events associated with hysteroscopic procedures are generally rare, but, with increasing operative complexity, it is now apparent that they are experienced more often. There exists a spectrum of complications that relate to generic components of procedures, such as patient positioning, anesthesia, and analgesia, to a number that are specific to intraluminal endoscopic surgery that largely comprise perforation and injuries to surrounding structures and blood vessels. Whereas a number of endoscopic procedures require the use of distending media, the response of premenopausal women to excessive absorption of nonionic fluids used for hysteroscopy is somewhat unique, and deserves special attention on the part the surgeon. There is also an increasing awareness of uncommon but problematic sequelae related to the use of monopolar radiofrequency uterine resectoscopes that involve thermal injury to the vulva and vagina. Furthermore, the uterus that has previously undergone hysteroscopic surgery may behave in unusual ways, at least in premenopausal women who experience menstruation or who become pregnant. Fortunately, better understanding of the mechanisms involved in these adverse events, as well as the use or development of a number of innovative devices, have collectively provided the opportunity to perform hysteroscopic and resectoscopic surgery in a manner that minimizes risk to the patient.

show abstract

Section: Regional and General Anesthesiamentioning

confidence: 99%

Complications of Hysteroscopic and Uterine Resectoscopic Surgery

Munro

Christianson

2015

Clinical Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

“…Otherwise, the women who underwent PCB have a better local analgesic effect thanks to lidocaine and mepivacaine action. During the PCB procedure, all operators always maintain verbal contact with the patients in order to provide emotional support and to reduce patient's perception of pain and alleviate their anxiety (verbal anesthesia) [6]. The total amount of time spent in the operating room was significantly less in the PCB group than in the GA group; this means that by doing all the interventions with PCB, it is possible to increase significantly the number of polypectomies performed per year (1 out of 4 more than with GA).…”

Section: Discussionmentioning

confidence: 99%

“…Given its safety and feasibility, operative hysteroscopy has become the standard for the treatment of endometrial polyps, which affect 10% of premenopausal and 20% of postmenopausal women with abnormal uterine bleeding including endometrial/endocervical polyps [2,3]. Most operative hysteroscopies are performed in the setting of an operating room under general anesthesia [4,5], causing major costs and risk of failure in patients with serious medical conditions such as hemodynamic instability, laryngospasm, bronchial asthma, and a previous reaction to general anesthesia [6]. The recent advantages in endoscopic instrumentation allow clinicians to perform quicker, less expensive, and safer operative hysteroscopy with local anesthesia plus moderate sedation [7].…”

Section: Discussmentioning

confidence: 99%

Parenterally Administered Moderate Sedation and Paracervical Block Versus General Anesthesia for Hysteroscopic Polypectomy: A Pilot Study Comparing Postoperative Outcomes

Centini

Calonaci

Lazzeri

et al. 2015

Journal of Minimally Invasive Gynecology

Self Cite

View full text Add to dashboard Cite

“…It is well known that pain and psychological stress may be associated with enhanced HR through the activation of the autonomic system (17)(18)(19), and feasible pain control and anesthesia may modulate those adaptive responses (17,20,21). Saddle anesthesia, which is performed at the lowest block level of subarachnoid or spinal anesthesia, is widely used in gynecological surgery, including hysteroscopy (22,23). The combination of low-dose saddle anesthesia and intravenous anesthesia, which improves intra-operative management and the post-operative quality of analgesia (13), is widely applied in gynecological surgeries in China (24); however, a common complication associated with spinal anesthesia is sinus bradycardia (25,26).…”

Section: Discussionmentioning

confidence: 99%

Effect of penehyclidine hydrochloride on heart rate variability in hysteroscopy

Liu

Pan

Yang

et al. 2015

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

In order to evaluate the effect of different doses of penehyclidine hydrochloride (penehyclidine) on heart rate (HR) and HR variability (HRV) in hysteroscopy, 180 patients (American Society of Anesthesiologists grade I-II) were randomized equally to three groups: 0.5 mg penehyclidine and intravenous anesthesia (group I), 1.0 mg penehyclidine and intravenous anesthesia (group II) and saddle anesthesia combined with intravenous anesthesia (control group). HR and HRV, including total power (TP), low-frequency power (LF), high-frequency power (HF) and the LF to HF ratio (LF/HF), were recorded prior and subsequent to the induction of anesthesia (T and T, respectively), following the start of surgery (T) and following completion of surgery (T). HR was lower at T than at T in the control patients, but no differences were observed in groups I and II. The HR at T was increased in group II compared with that in group I. TP in group II was significantly higher compared with that in group I at T. At T and at T, the LF and HF values were lower in group I than those in the controls. Patients in group II also had higher LF and HF at T than patients in group I. The HF was higher at T than that at T in the controls; however, the HF and LF did not change significantly within groups I and II. No significant differences were observed in the LF/HF ratio among the three groups. At a dose of 0.5 mg, penehyclidine stabilized HRV and did not alter the autonomic nervous modulation of HR. A penehyclidine dose of 1.0 mg may be superior to a dose of 0.5 mg in maintaining HR, but is less effective at balancing sympathetic and parasympathetic activity.

show abstract

Low-Dose Spinal Anesthesia with Hyperbaric Bupivacaine with Intrathecal Fentanyl for Operative Hysteroscopy: A Case Series Study

Cited by 22 publications

References 19 publications

Complications of Hysteroscopic and Uterine Resectoscopic Surgery

Complications of Hysteroscopic and Uterine Resectoscopic Surgery

Parenterally Administered Moderate Sedation and Paracervical Block Versus General Anesthesia for Hysteroscopic Polypectomy: A Pilot Study Comparing Postoperative Outcomes

Effect of penehyclidine hydrochloride on heart rate variability in hysteroscopy

Contact Info

Product

Resources

About