Anesthesia for hysteroscopy: how to do better?
Hysteroscopy is a procedure for the study of the uterine cavity using endoscopic equipment. The method consists in the introduction of a special tube into the body cavity through the cervix. The procedure is not a complex manipulation, but painful for women. Pain is the study associated with the expansion of the cervix, which is carried out before the introduction into the cavity of the hysteroscope.
In order to minimize pain during the procedure, illustrates the use of anesthesia. Type of anesthesia in each case is determined individually. Hysteroscopy is performed, on average, for 15-20 minutes. However, there are times when the procedure takes an hour or more. A diagnostic procedure is performed quickly, a study surgery takes more time.
- Regional anesthesia. It allows you to remain conscious patient in the absence of pain and no epidural spinalnaya.
Question about using a specific type of anesthesia is decided by the doctor after examining the women and collected detailed medical history.
Special attention should be paid to the presence of severe somatic diseases, allergic reactions to medications, General condition of the body.
When you can not do a specific type of anesthesia? What contraindications are there?
- Local anesthesia is not done in cases when the patient has an allergic reaction to the introduction of anesthetics (Lidocaine, Novocaine, etc.). Because the body’s response to repeated administration of the allergen can be unpredictable, until the development of anaphylactic shock, the use of local anesthesia is prohibited. It is also desirable the use of drugs of this group with signs of renal failure. Planning a lengthy diagnostic or therapeutic procedures is also a contraindication to the administration of local anesthetics.
- General anesthesia is contraindicated in the following cases:
- atrial fibrillation;
- conduction disorders of the heart;
- acute coronary condition, including myocardial infarction;
- some types of angina;
- acute inflammation of the liver from toxic and viral origin;
- violations of the liver and kidney with symptoms of deficiency;
- cirrhosis of the liver;
- diseases of the respiratory system of inflammatory and obstructive character;
- active foci of infection in the body (erysipelas, suppurative processes, sepsis);
- viral and bacterial diseases of the respiratory tract.
- Regional anesthesia is not possible in the following cases:
- allergic reactions or hypersensitivity to local anaesthetics;
- cardiac rhythm and conduction heart;
- low blood pressure;
- foci of infection at the injection of the anesthetic;
- a bleeding disorder, bleeding tendency.
General anesthesia is the most effective method of pain relief.
In addition, it is the most comfortable for the patient, especially during prolonged medical procedures. The disadvantage of General anesthesia is the presence of a large number of contraindications.
The conduct of anesthesia may lead to development of complications associated with incorrect choice of anesthesia or individual characteristics of the organism. What complications can occur?
Local anesthesia can lead to:
- overdose of anesthetic;
- unwanted reactions of the cardiovascular system due to contact of the anesthetic in the bloodstream;
- septic complications in case of violation of the rules of asepsis and antisepsis;
- local edema is the result of intolerance to the drug.
After General anesthesia can be:
- pain in the throat, larynx, associated with the introduction of the laryngoscope, the endotracheal tube;
- brain damage that manifests in impaired vision, the development of encephalopathy;
- infection of the respiratory system;
- death due to disorders of the cardiovascular system.
Regional anesthesia may be complicated by:
- the formation of hematoma at the injection of the anesthetic;
- lowering blood pressure and slowing of heart rhythm;
- back pain;
- urinary retention.
Complications of anesthesia occur rarely and depend on the competence of a doctor. If the anesthesia is properly selected and the manipulation is done professionally, the consequences are usually minor or absent altogether.