POSTOPERATIVE CEREBRAL EDEMA AFTER TRANSCERVICAL ENDOMETRIAL RESECTION AND UTERINE IRRIGATION WITH 1-CENTER-DOT-5-PERCENT GLYCINE

Absorption of irrigating solution during transcervical resection of en dometrium can cause dilutional hyponatraemia, nausea, and cerebral oed ema. We studied 6 patients who absorbed more than 1500 mL of 1.5% glyc ine, and 14 patients who absorbed less. Cerebral oedema was diagnosed by blinded, paired comparison of computed tomography (CT) scans 3-6 ho urs and 3-6 days after operation. The absorbed volume of irrigating gl ycine solution was correlated with peroperative decrease in serum sodi um. 10 patients who absorbed 500 mL of glycine or more had postoperati ve nausea, with cerebral oedema suspected in 9. None of the 10 patient s who absorbed less than 500 mL had nausea; changes on CT scan suggest ive of cerebral edema were found in 1. 8 patients who absorbed 1000 mL or more had a decrease in serum sodium of 10 mmol/L or more, nausea, and cerebral oedema on CT scan. Cerebral oedema may contribute to the development of postoperative nausea in patients undergoing transcervic al surgery who absorb more than 500 mL of 1.5% glycine irrigating solu tion.