MONITORING FLUID ABSORPTION USING 1-PERCENT ETHANOL-TAGGED GLYCINE DURING OPERATIVE HYSTEROSCOPY

Study Objective. To assess the value oi expired breath ethanol as a ma rker oi irrigating fluid absorption during hysteroscopic surgery using 1% ethanol-tagged 1.5% glycine. Design. Prospective analysis. Setting . Endoscopy training center of a university hospital. Patients. Forty- eight women undergoing major hysteroscopic surgery for menorrhagia (40 transcervical endometrial resections, 8 rollerball endometrial ablati ons). Interventions. Expired breath ethanol and venous blood samples w ere taken before and at 10-minute intervals during surgery. Volumetric absorption of irrigating fluid was checked at the same time. Measurem ents and Main Results. Expired breath ethanol concentration, serum eth anol, several biochemical variables, and volume of absorbed irrigating fluid (direct and indirect) were measured. There was a linear positiv e correlation (r = 0.86, p < 0.001) between direct vascular absorption of the irrigating fluid and expired breath ethanol concentration. Pre diction can be given with 95% confidence that if the alcolmeter readin g is below 0.45%, the volume of irrigating fluid absorbed is below 200 0 ml. No significant correlation was seen between expired breath ethan ol and indirect fluid absorption. Conclusions. As it is not possible t o distinguish direct and indirect fluid absorption during hysteroscopi c surgery, measuring expired breath ethanol is insufficient to assess overall fluid balance, and continuous volumetric assessment is still r equired.