Severe intraoperative hyponatremia associated with the absorption of irrigation fluid during hysteroscopic myomectomy: a case report

• Published in: Journal of clinical anesthesia Vol. 23; no. 8; pp. 649 - 652
• Main Authors: Woo, Young Cheol, MD, Kang, Hyun, MD, Cha, Su Man, MD, Jung, Yong Hun, MD, Kim, Jin Yun, MD, Koo, Gill Hoi, MD, Park, Sun Gyoo, MD, Baek, Chong Wha, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-12-2011; Elsevier; Elsevier Limited
• Subjects: Adult; Anesthesia; Anesthesia & Perioperative Care; Anesthesia, General - methods; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood pressure; Cardiovascular Diseases - etiology; Continuous renal replacement therapy; Female; Fluids; Humans; Hypertonic saline; Hyponatremia; Hyponatremia - etiology; Hyponatremia - physiopathology; Hysteroscopy; Hysteroscopy - methods; Intraoperative Complications; Irrigation fluid; Leiomyoma - surgery; Medical sciences; Pain Medicine; Pulmonary Edema - etiology; Saline Solution, Hypertonic - therapeutic use; Severity of Illness Index; Sodium - blood; Therapeutic Irrigation - adverse effects; Therapeutic Irrigation - methods; Uterine Neoplasms - surgery; Ventilation; Hysteroscopy; Hypertonic saline; Hyponatremia; Irrigation fluid; Continuous renal replacement therapy; Irrigation; Hydroelectrolytic balance disorder; Replacement therapy; Intraoperative; Inorganic element; Case study; Metabolic disorder; Sodium; Continuous renal; Anesthesia
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2011.03.003

Abstract A case of severe hyponatremia with accompanying pulmonary edema and cardiovascular instability during a hysteroscopic myomectomy with general anesthesia is presented. The patient's sodium value decreased to 87 mmol/L. She was managed with aggressive maneuvers, including an infusion of 3% hypertonic saline. The patient's serum sodium increased to 113 mmol/L at the end of the operation, and it was increased up to 138 mmol/L at 48 hours. The patient recovered completely without neurologic sequelae.