Ethanol monitoring of irrigating fluid absorption in transcervical resection of the endometrium

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Abstract
Background. We evaluated the precision in using ethanol to indicate and quantify absorption of irrigating fluid during transcervical resection of the endometrium. Methods. The ethanol concentration in the expired breath, the serum sodium level, the blood loss and the volumetric fluid balance were measured over 10-min periods during 62 operations. A solution containing glycine 1.5% and ethanol 1% was used to irrigate the uterus. Results. Most principles previously outlined for ethanol monitoring in transurethral prostatic surgery could also be applied in endometrial resection. In the 21 patients who showed the intravascular pattern of ethanol changes, the breath alcohol measurement corrected for absorption time predicted the volume of irrigant absorbed {up to 2,531 ml) with a standard error of 230 ml at the end of any 10-min period of absorption. Repeated measurement of serum sodium indicated intravascular fluid absorption with practically the same precision as the breath test. Extravascular absorption was found in 14 patients. In these operations, the volume of irrigant absorbed (up to 1,767 ml) could be predicted with a standard error of 92 ml from the ethanol concentration at the plateau level attained after absorption had occurred. Conclusion. Ethanol monitoring is precise enough to allow monitoring of irrigating fluid absorption in endometrial resection.