Abstract
EVALUATION OF INTRAOCULAR PRESSURE IN HYSTEROSCOPIC SURGERY
ABSTRACT
Objective: To assess the intraocular pressure (IOP) alterations before, during, and after hysteroscopy and to compare the measurements of two different hysteroscopy methods.
Materials and Methods: In this retrospective study included 52 female patients who applied to the Obstetrics and Gynecology clinic of a tertiary university hospital between October 2017 and February 2020 and underwent hysteroscopy procedures. The participants were age, body mass index and preoperative IOP matched and separated into 2 groups according to the hysteroscopy method; monopolar probe-glycin 1.5% solution (MG) and bipolar probe-isotonic solution (BI). The IOP measurements were performed preoperatively, intraoperatively, and 12 hours after the procedure by using a portable tonometer.
Results: The mean age of the participants was 50.69±7.56 years in the MG and 52.69±6.66 years in the BI groups. The mean preoperative, intraoperative and postoperative IOP measurements of the MG and BI groups were 13.69 ± 2.22, 26.62 ± 3.08, 14.69 ± 2.57 mm-Hg and 13.38 ± 1.81, 20.31 ± 2.05, 13.69 ± 1.59 mm-Hg, respectively. The mean intraoperative IOP values were significantly higher than preoperative and postoperative measurements in both groups. However, there was no significant difference between the mean intraoperative and postoperative values in any of the groups.
Conclusion: The IOP peaks occurred during hysteroscopy in both methods and the utilization of monopolar probe and glycine 1.5% solution caused significantly higher fluctuations. Therefore, close monitoring of intraoperative IOP may help to prevent severe ocular complications.
Keywords: Glycine; hysteroscopy; intraocular pressure; tonometry
Keywords
References
- 1. Sethi N, Chaturvedi R, Kumar K. Operative hysteroscopy intravascular absorption syndrome: A bolt from the blue. Indian J Anaesth. 2012;56:179-182. doi:10.4103/0019-5049.96342.
- 2. Stamatellos I, Koutsougeras G, Karamanidis D, Stamatopoulos P, Timpanidis I. Bontis, J. Results after hysteroscopic management of premenopausal patients with dysfunctional uterine bleeding or intrauterine lesions. Clin Exp Obstet Gynecol. 2007;34:35-38.
- 3. Aydeniz B, Gruber IV, Schauf B, Kurek R, Meyer A, Wallwiener D. A multicenter survey of complications associated with 21 676 operative hysteroscopies. Eur J Obstet Gynecol Reprod Biol. 2002;104:160-164. doi:10.1016/S0301-2115(02)00106-9.
- 4. Propst AM, Liberman RF, Harlow BL, Ginsburg ES. Complications of hysteroscopic surgery: Predicting patients at risk. Obstet Gynecol. 2000;96:517-520. doi:10.1016/S0029-7844(00)00958-3.
- 5. Tammam AE, Ahmed HH, Abdella AH, Taha SAM. Comparative study between monopolar electrodes and bipolar electrodes in hysteroscopic surgery. J Clin Diagnostic Res. 2015;9:QC11-QC13. doi:10.7860/JCDR/2015/16476.6792.
- 6. Berg A, Sandvik L, Langebrekke A, Istre O. A randomized trial comparing monopolar electrodes using glycine 1.5% with two different types of bipolar electrodes (TCRis, Versapoint) using saline, in hysteroscopic surgery. Fertil Steril. 2009;91:1273-1278. doi:10.1016/j.fertnstert.2008.01.083.
- 7. Witz CA, Silverberg KM, Burns WN, Schenken RS, Olive DL. Complications associated with the absorption of hysteroscopic fluid media. Fertil Steril. 1993;60:745-756. doi:10.1016/S0015-0282(16)56268-2.
- 8. Hahn RG. Is glycine a safe irrigating fluid? [1]. Acta Anaesthesiol Scand. 1997;41:545. doi:10.1111/j.1399-6576.1997.tb04740.x.
- 9. Karci A, Erkin Y. Transient blindness following hysteroscopy. J Int Med Res. 2003;31:152-155. doi:10.1177/147323000303100213.
- 10. Pramod A, Rajagopal S, Padmanabha Iyer V, Murthy HS. Glycine induced acute transient postoperative visual loss. Indian J Anaesth. 2015;59:318-319. doi:10.4103/0019-5049.156890.
- 11. Cunningham AJ, Barry P. Intraocular pressure -physiology and implications for anaesthetic management. Can Anaesth Soc J. 1986;33:195-208. doi:10.1007/BF03010831.
- 12. Nuzzi R, Tridico F. Ocular Complications in Laparoscopic Surgery: Review of Existing Literature and Possible Prevention and Treatment. Semin Ophthalmol. 2016;31:584-592. doi:10.3109/08820538.2015.1009557.
- 13. Van Keer K, Breda JB, Pinto LA, Stalmans I, Vandewalle E. Estimating Mean Ocular Perfusion Pressure Using Mean Arterial Pressure and Intraocular Pressure. Invest Ophthalmol Vis Sci. 2016;57:2260. doi:10.1167/iovs.16-19375.
- 14. Panek WC, Boothe WA, Lee DA, Zemplenyi E, Pettit TH. Intraocular pressure measurement with the Tono-Pen through soft contact lenses. Am J Ophthalmol. 1990;109:62-65. doi:10.1016/S0002-9394(14)75580-1.
- 15. Walick KS, Kragh JE, Ward JA, Crawford JJ. Changes in intraocular pressure due to surgical positioning: Studying potential risk for postoperative vision loss. Spine (Phila Pa 1976). 2007;32:2591-2595. doi:10.1097/BRS.0b013e318158cc23.
- 16. Pınar HU, Kaşdoğan ZEA, Başaran B, Çöven İ, Karaca Ö, Doğan R. The effect of spinal versus general anesthesia on intraocular pressure in lumbar disc surgery in the prone position: A randomized, controlled clinical trial. J Clin Anesth. 2018;46:54-58. doi:10.1016/j.jclinane.2018.01.026.
- 17. Arslan AK, Yaşar Ş, Çolak C, Yoloğlu S. WSSPAS: An Interactive Web Application for Sample Size and Power Analysis with R Using Shiny. Turkiye Klin J Biostat. 2018;10:224-246. doi:10.5336/biostatic.2018-62787.
- 18. Motashaw ND, Dave S. Vision disturbances after operative hysteroscopy. J Am Assoc Gynecol Laparosc. 1999;6:213-215. doi:10.1016/S1074-3804(99)80106-6.
- 19. Hahn RG. Fluid absorption in endoscopic surgery. Br J Anaesth. 2006;96:8-20. doi:10.1093/bja/aei279.
- 20. Roy KK, Kansal Y, Subbaiah M, Kumar S, Sharma JB, Singh N. Hysteroscopic septal resection using unipolar resectoscope versus bipolar resectoscope: Prospective, randomized study. J Obstet Gynaecol Res. 2015;41:952-956. doi:10.1111/jog.12646.
- 21. Umranikar S, Clark TJ, Saridogan E, Miligkos D, Arambage K, Torbe E et al. BSGE/ESGE guideline on management of fluid distension media in operative hysteroscopy. Gynecol Surg. 2016;13:289-303. doi:10.1007/s10397-016-0983-z.
- 22. Ozcan MS, Praetel C, Tariq Bhatti M, Gravenstein N, Mahla ME, Seubert CN. The effect of body inclination during prone positioning on intraocular pressure in awake volunteers: A comparison of two operating tables. Anesth Analg. 2004;99:1152-1158. doi:10.1213/01.ANE.0000130851.37039.50.
- 23. Hunt K, Bajekal R, Calder I, Meacher R, Eliahoo J, Acheson JF. Changes in intraocular pressure in anesthetized prone patiente. J Neurosurg Anesthesiol. 2004;16:287-290. doi:10.1097/00008506-200410000-00005.
- 24. Cheng MA, Todorov A, Tempelhoff R, McHugh T, Crowder CM, Lauryssen C. The effect of prone positioning on intraocular pressure in anesthetized patients. Anesthesiology. 2001;95:1351-1355. doi:10.1097/00000542-200112000-00012.
- 25. Awad H, Santilli S, Ohr M, Roth A, Yan W, Fernandez S et al. The effects of steep trendelenburg positioning on intraocular pressure during robotic radical prostatectomy. Anesth Analg. 2009;109:473-478. doi:10.1213/ane.0b013e3181a9098f.
- 26. Sutton S, Link T, Makic MBF. A Quality Improvement Project for Safe and Effective Patient Positioning During Robot-Assisted Surgery. AORN J. 2013;97:448-456. doi:10.1016/j.aorn.2013.01.014.
- 27. Lam AKC, Douthwaite WA. Does the change of anterior chamber depth or/and episcleral venous pressure cause intraocular pressure change in postural variation? Optom Vis Sci. 1997;74:664-667. doi:10.1097/00006324-199708000-00028.
- 28. Roesch RP, Stoelting RK, Lingeman JE, Kahnoski RJ, Backes DJ, Gephardt SA. Ammonia toxicity resulting from glycine absorption during a transurethral resection of the prostate. Anesthesiology. 1983;58:577-579. doi:10.1097/00000542-198306000-00021.
Abstract
ÖZET
Amaç: Histeroskopi öncesinde, esnasında ve sonrasında göz içi basıncı (GİB) değişimlerini değerlendirmek ve iki farklı histeroskopi metodunda ölçümleri karşılaştırmak
Gereç ve Yöntem: Bu retrospektif çalışmaya, Ekim 2017-Şubat 2020 tarihleri arasında bir üçüncü basamak üniversite hastanesinin Kadın Hastalıkları ve Doğum kliniğine başvuran ve histeroskopi işlemi uygulanan 52 kadın hasta dahil edildi. Katılımcılar yaş, vücut kitle indeksi ve cerrahi öncesi GİB değerlerine göre eşleştirildi ve histeroskopi yöntemine iki eşit gruba ayrıldı; monopolar prob-glisin 1.5% solüsyon (MG) ve bipolar prob- izotonik solüsyon (BI). Cerrahi öncesi, esnasında ve 12 saat sonrasında GİB ölçümleri taşınabilir tonometri cihazı kullanılarak yapıldı.
Bulgular: Katılımcıların ortalama yaşı MG grubunda 50.69±7.56 yıl, BI grubunda ise 52.69±6.66 yıldı. Cerrahi öncesinde, esnasında ve sonrasında ortalama GİB ölçümleri MG grubunda sırasıyla 13.69 ± 2.22, 26.62 ± 3.08, 14.69 ± 2.57 mm-Hg ve BI grubunda sırasıyla 13.38 ± 1.81, 20.31 ± 2.05, 13.69 ± 1.59 mm-Hg idi. Her iki grupta da cerrahi esnasında ortalama GİB ölçümleri cerrahi öncesi ve sonrasına kıyasla anlamlı olarak yüksekti. Ancak, cerrahi öncesi ve sonrası değerler arasında her iki grupta da anlamlı fark yoktu.
Sonuç: Her iki yöntemde de histeroskopi esnasında GİB pikleri meydana geldi ve monopolar prob ve glisin 1.5% solüsyonu kullanımı belirgin olarak daha yüksek dalgalanmalara neden oldu. Bu nedenle, cerrahi esnasında GİB’nın yakın izlemi ciddi oküler komplikasyonların gelişimini önleyebilir.
Anahtar Kelimeler: Glisin; histeroskopi; göz içi basıncı; tonometri
Keywords
References
- 1. Sethi N, Chaturvedi R, Kumar K. Operative hysteroscopy intravascular absorption syndrome: A bolt from the blue. Indian J Anaesth. 2012;56:179-182. doi:10.4103/0019-5049.96342.
- 2. Stamatellos I, Koutsougeras G, Karamanidis D, Stamatopoulos P, Timpanidis I. Bontis, J. Results after hysteroscopic management of premenopausal patients with dysfunctional uterine bleeding or intrauterine lesions. Clin Exp Obstet Gynecol. 2007;34:35-38.
- 3. Aydeniz B, Gruber IV, Schauf B, Kurek R, Meyer A, Wallwiener D. A multicenter survey of complications associated with 21 676 operative hysteroscopies. Eur J Obstet Gynecol Reprod Biol. 2002;104:160-164. doi:10.1016/S0301-2115(02)00106-9.
- 4. Propst AM, Liberman RF, Harlow BL, Ginsburg ES. Complications of hysteroscopic surgery: Predicting patients at risk. Obstet Gynecol. 2000;96:517-520. doi:10.1016/S0029-7844(00)00958-3.
- 5. Tammam AE, Ahmed HH, Abdella AH, Taha SAM. Comparative study between monopolar electrodes and bipolar electrodes in hysteroscopic surgery. J Clin Diagnostic Res. 2015;9:QC11-QC13. doi:10.7860/JCDR/2015/16476.6792.
- 6. Berg A, Sandvik L, Langebrekke A, Istre O. A randomized trial comparing monopolar electrodes using glycine 1.5% with two different types of bipolar electrodes (TCRis, Versapoint) using saline, in hysteroscopic surgery. Fertil Steril. 2009;91:1273-1278. doi:10.1016/j.fertnstert.2008.01.083.
- 7. Witz CA, Silverberg KM, Burns WN, Schenken RS, Olive DL. Complications associated with the absorption of hysteroscopic fluid media. Fertil Steril. 1993;60:745-756. doi:10.1016/S0015-0282(16)56268-2.
- 8. Hahn RG. Is glycine a safe irrigating fluid? [1]. Acta Anaesthesiol Scand. 1997;41:545. doi:10.1111/j.1399-6576.1997.tb04740.x.
- 9. Karci A, Erkin Y. Transient blindness following hysteroscopy. J Int Med Res. 2003;31:152-155. doi:10.1177/147323000303100213.
- 10. Pramod A, Rajagopal S, Padmanabha Iyer V, Murthy HS. Glycine induced acute transient postoperative visual loss. Indian J Anaesth. 2015;59:318-319. doi:10.4103/0019-5049.156890.
- 11. Cunningham AJ, Barry P. Intraocular pressure -physiology and implications for anaesthetic management. Can Anaesth Soc J. 1986;33:195-208. doi:10.1007/BF03010831.
- 12. Nuzzi R, Tridico F. Ocular Complications in Laparoscopic Surgery: Review of Existing Literature and Possible Prevention and Treatment. Semin Ophthalmol. 2016;31:584-592. doi:10.3109/08820538.2015.1009557.
- 13. Van Keer K, Breda JB, Pinto LA, Stalmans I, Vandewalle E. Estimating Mean Ocular Perfusion Pressure Using Mean Arterial Pressure and Intraocular Pressure. Invest Ophthalmol Vis Sci. 2016;57:2260. doi:10.1167/iovs.16-19375.
- 14. Panek WC, Boothe WA, Lee DA, Zemplenyi E, Pettit TH. Intraocular pressure measurement with the Tono-Pen through soft contact lenses. Am J Ophthalmol. 1990;109:62-65. doi:10.1016/S0002-9394(14)75580-1.
- 15. Walick KS, Kragh JE, Ward JA, Crawford JJ. Changes in intraocular pressure due to surgical positioning: Studying potential risk for postoperative vision loss. Spine (Phila Pa 1976). 2007;32:2591-2595. doi:10.1097/BRS.0b013e318158cc23.
- 16. Pınar HU, Kaşdoğan ZEA, Başaran B, Çöven İ, Karaca Ö, Doğan R. The effect of spinal versus general anesthesia on intraocular pressure in lumbar disc surgery in the prone position: A randomized, controlled clinical trial. J Clin Anesth. 2018;46:54-58. doi:10.1016/j.jclinane.2018.01.026.
- 17. Arslan AK, Yaşar Ş, Çolak C, Yoloğlu S. WSSPAS: An Interactive Web Application for Sample Size and Power Analysis with R Using Shiny. Turkiye Klin J Biostat. 2018;10:224-246. doi:10.5336/biostatic.2018-62787.
- 18. Motashaw ND, Dave S. Vision disturbances after operative hysteroscopy. J Am Assoc Gynecol Laparosc. 1999;6:213-215. doi:10.1016/S1074-3804(99)80106-6.
- 19. Hahn RG. Fluid absorption in endoscopic surgery. Br J Anaesth. 2006;96:8-20. doi:10.1093/bja/aei279.
- 20. Roy KK, Kansal Y, Subbaiah M, Kumar S, Sharma JB, Singh N. Hysteroscopic septal resection using unipolar resectoscope versus bipolar resectoscope: Prospective, randomized study. J Obstet Gynaecol Res. 2015;41:952-956. doi:10.1111/jog.12646.
- 21. Umranikar S, Clark TJ, Saridogan E, Miligkos D, Arambage K, Torbe E et al. BSGE/ESGE guideline on management of fluid distension media in operative hysteroscopy. Gynecol Surg. 2016;13:289-303. doi:10.1007/s10397-016-0983-z.
- 22. Ozcan MS, Praetel C, Tariq Bhatti M, Gravenstein N, Mahla ME, Seubert CN. The effect of body inclination during prone positioning on intraocular pressure in awake volunteers: A comparison of two operating tables. Anesth Analg. 2004;99:1152-1158. doi:10.1213/01.ANE.0000130851.37039.50.
- 23. Hunt K, Bajekal R, Calder I, Meacher R, Eliahoo J, Acheson JF. Changes in intraocular pressure in anesthetized prone patiente. J Neurosurg Anesthesiol. 2004;16:287-290. doi:10.1097/00008506-200410000-00005.
- 24. Cheng MA, Todorov A, Tempelhoff R, McHugh T, Crowder CM, Lauryssen C. The effect of prone positioning on intraocular pressure in anesthetized patients. Anesthesiology. 2001;95:1351-1355. doi:10.1097/00000542-200112000-00012.
- 25. Awad H, Santilli S, Ohr M, Roth A, Yan W, Fernandez S et al. The effects of steep trendelenburg positioning on intraocular pressure during robotic radical prostatectomy. Anesth Analg. 2009;109:473-478. doi:10.1213/ane.0b013e3181a9098f.
- 26. Sutton S, Link T, Makic MBF. A Quality Improvement Project for Safe and Effective Patient Positioning During Robot-Assisted Surgery. AORN J. 2013;97:448-456. doi:10.1016/j.aorn.2013.01.014.
- 27. Lam AKC, Douthwaite WA. Does the change of anterior chamber depth or/and episcleral venous pressure cause intraocular pressure change in postural variation? Optom Vis Sci. 1997;74:664-667. doi:10.1097/00006324-199708000-00028.
- 28. Roesch RP, Stoelting RK, Lingeman JE, Kahnoski RJ, Backes DJ, Gephardt SA. Ammonia toxicity resulting from glycine absorption during a transurethral resection of the prostate. Anesthesiology. 1983;58:577-579. doi:10.1097/00000542-198306000-00021.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Articles |
| Authors | |
| Publication Date | December 15, 2020 |
| Submission Date | September 7, 2020 |
| Published in Issue | Year 2020 Volume: 10 Issue: 4 |
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