Journal of Ultrasound in Medicine, Vol 16, Issue 3 195-199, Copyright © 1997 by American Institute of Ultrasound in Medicine
Transvaginal ultrasonographic assessment of Hyskon or lactated Ringer's solution instillation after laparoscopy: randomized, controlled study
C. K. Sites, B. A. Jensen, J. L. Glock, J. A. Blackman, G. J. Badger, J. V. Johnson and J. R. Brumsted
Department of Obstetrics and Gynecology, University of Vermont, Burlington 05405-0068, USA.
We sought to evaluate two common fluids placed in the pelvis after pelvic
surgery for their ability to remain in the pelvis for a time thought
adequate for prevention of adhesions. Thirteen patients undergoing
operative laparoscopy were randomized to receive 250 ml 32% dextran 70
(Hyskon), 250 ml lactated Ringer's solution, or no fluid (control) at the
end of surgery. Serial transvaginal ultrasonograms were obtained at 1 hr, 3
hr, 6 hr, 24 hr, 96 hr (4 days), and 168 hr (7 days) after surgery.
Patients were asked about side effects of fluid instillation. The volume of
lactated Ringer's solution declined rapidly after instillation, with no
significant difference from control at 24 hr (12 ml versus 7 ml). The
volume of Hyskon did not decline rapidly by 24 hr and remained higher than
the volume in controls or those receiving lactated Ringer's solution (188
ml, P = 0.003). Although the volume of Hyskon remained higher than that of
lactated Ringer's solution or fluid volume in control patients by days 4
and 7, this difference did not reach statistical significance (45 ml versus
7 ml and 14 ml respectively, P = 0.39, on day 4). Patients in all groups
noted abdominal pain. One patient who received Hyskon developed severe
vulvar edema and another developed dyspnea. We conclude that the volume of
Hyskon in the peritoneal cavity after laparoscopy does not decline as
rapidly as does that of lactated Ringer's solution; however, significant
side effects may limit its usefulness. Transvaginal ultrasonography is
useful in monitoring fluids placed in the pelvis for prevention of
adhesions.
