Hysteroscopy

Hysteroscopy

Anesthesia type	Local Neuraxial MAC GA
Airway	Local: Non-invasive O2 Regional: Non-invasie O2 GA: LMA or ETT
Lines and access	PIV x 1
Monitors	Std ASA
Primary anesthetic considerations
Preoperative	If procedure is being done for uterine bleeding, consider hypovolemia and anemia
Intraoperative	Standard induction
Postoperative	PONV
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Hysteroscopy is used to diagnose or treat problems of the uterus.

Preoperative management

Patient evaluation

System	Considerations
Airway
Neurologic
Cardiovascular
Pulmonary
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

• Hgb/Hct if bleeding
• Pregnancy test (if indicated)

Regional and neuraxial techniques

• A T10 sensory level is sufficient
• Spinal
• Epidural
• Combined spinal/epidural (CSE)

Intraoperative management

Maintenance and surgical considerations

• When cervix is grasped and dilated, patient may have excessive vagal nerve stimulation

Postoperative management

Potential complications

• Air embolism
  • Can occur with the use of gas dissension medium, although low-viscosity fluids are more commonly used today
• Fluid overload
  • Can occur with the use of low-viscosity dissension media
• Infection
• Bleeding

Procedure variants

	Variant 1	Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications