Hysteroscopy

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Hysteroscopy
Anesthesia type

General, neuraxial, or local

Airway

Noninvasive O2 if neuraxial or local LMA/ETT if GA

Lines and access

PIV

Monitors

Standard

Primary anesthetic considerations
Preoperative

If procedure is being done for uterine bleeding, consider hypovolemia and anemia

Intraoperative
Postoperative

PONV

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Hysteroscopy is used to diagnose or treat problems of the uterus.

Overview

Indications

Surgical procedure

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)

Operating room setup

Patient preparation and premedication

Regional and neuraxial techniques

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

Intraoperative management

Monitoring and access

Induction and airway management

Positioning

Maintenance and surgical considerations

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

Emergence

Postoperative management

Disposition

Pain 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

References