title: Low-dose spinal anesthesia with hyperbaric bupivacaine with intrathecal fentanyl for operative hysteroscopy: a case series study.
abstract: OBJECTIVE
  To estimate the efficacy and tolerability of low dose spinal anesthesia during operative hysteroscopy in a group of patients with high surgical risks.
  
  
  METHODS
  Case series study (Canadian Task Force Classification II-2).
  
  
  METHODS
  Tertiary centers for women health care.
  
  
  METHODS
  A total of 47 women affected by endometrial polyps (n = 32), myomas (n = 8), and abnormal uterine bleeding (n = 7) scheduled for inpatient operative hysteroscopy.
  
  
  METHODS
  Transvaginal ultrasonography; office diagnostic hysteroscopy; preoperative evaluation of American Society of Anesthesiologist (ASA) classification; inpatient operative hysteroscopy; low-dose spinal anesthesia with hyperbaric bupivacaine; compilation of a questionnaire.
  
  
  METHODS
  Practicability and patients' subjective experiences with spinal anesthesia; duration of cervical dilation and for operative hysteroscopy; infusion volume needed; incidence of surgical complications.
  
  
  RESULTS
  Resectoscopy was performed in all patients, with the exception of 1 woman (2.1%) in which spinal anesthesia was unsuccessful. No statistically significant differences were noted among groups in terms of intra- and peri-operative findings. Sensory block induced by spinal anesthesia was suitable for surgery in all patients, and side effects occurred far less frequently than mentioned in the literature. Data reported in the questionnaire revealed that 93.5% of women would choose a spinal anesthesia again for a potential operative hysteroscopy in the future, since for 89.1% of them long lasting anesthesia is of relevance.
  
  
  CONCLUSIONS
  Low-dose spinal anesthesia is a feasible technique in the inpatient setting for operative hysteroscopy in women with high surgical risks.
authors: Department of Pediatrics, Obstetrics and Reproductive Medicine, Section of Obstetrics and Gynecology, University of Siena, Siena, Italy. florio@unisi.it
authors: Pasquale
authors: P
authors: Florio
authors: Rosa
authors: R
authors: Puzzutiello
authors: Marco
authors: M
authors: Filippeschi
authors: Pasquale
authors: P
authors: D'Onofrio
authors: Liliana
authors: L
authors: Mereu
authors: Rosita
authors: R
authors: Morelli
authors: Daniele
authors: D
authors: Marianello
authors: Pietro
authors: P
authors: Litta
authors: Luca
authors: L
authors: Mencaglia
authors: Felice
authors: F
authors: Petraglia
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage*; D000328:Adult; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D015907:Hysteroscopy; D007889:Leiomyoma / Q000601:surgery; D008875:Middle Aged; D017060:Patient Satisfaction; D011127:Polyps / Q000601:surgery; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014592:Uterine Hemorrhage / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery
chemical_list: D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine