SORBITOL 2.5-PERCENT MANNITOL 0.54-PERCENT IRRIGATION SOLUTION FOR HYSTEROSCOPIC ENDOMETRIAL ABLATION SURGERY

Purpose: To determine if systemic absorption of sorbitol 2.5%/mannitol 0.54% irrigation solution (165 mosm.L-1) during hysteroscopic endomet rial ablation with diathermy is associated with hyponatraemia and hypo osmolality. Methods: In 35 day surgery patients in a university hospit al we measured baseline preoperative variables: serum sodium and creat inine concentrations and osmolality, haematocrit, haemoglobin, urine o smolality and sodium concentration, and weight, Fractional excretion o f sodium (FENa) was calculated. The same observations were obtained po stoperatively before discharge (one hour post resection), Volumes of i ntraoperative fluid irrigation intravasation and perioperative intrave nous fluid absorption (lactated Ringer's solution) were estimated clin ically (volumetric). Results: The mean (+/- SD) serum sodium concentra tion preoperatively was 140.3 +/- 2.4 mmol.L-1; and post operatively, 139.7 +/- 2.2 mmol.L-1 (P=NS). The serum osmolality decreased from 285 .4 +/- 4.5 to 282.6 +/- 4.1 mmol.kg(-1) (P < 0.001). The mean volume o f intravasated irrigation fluid was 26.4 ml (range 0-300). During the same time, the FENa increased from 0.57% to 0.79% (P < 0.001). Conclus ion: In these patients, closely and continuously observed for imbalanc e between infused and collected irrigation fluid, there was no clinica l evidence for hyponatraemic hypoosmolality. However, there was a smal l 1% +/- 1.5% (mean +/- SD; range -3.4 to 3.6%) decrease in plasma osm olality despite adequate blood volumes as shown by urinary sodium indi ces.