Intravascular Absorption of Glycine Irrigating Solution during Shoulder Arthroscopy: A Case Report and Follow-up Study

A 1.5% solution of glycine irrigating fluid is commonly used in urologic and gynecologic endoscopy and in arthroscopy. 1-3 However, intravascular absorption of this solution may cause cardiovascular, neurologic, visual disorders and water intoxication that can occasionally be fatal, generally because of cerebral edema. 2,4,5 Burkhart et al. 3 reported that transient blindness occurred after a knee arthroscopy, and suggested that this may be due to glycine toxicity. We report a case of an unexplained death due to cerebral edema in a healthy patient who had undergone a shoulder arthroscopy. Because of our concerns regarding possible glycine toxicity, we then carried out a prospective examination of changes in serum glycine concentration in 22 patients during identical procedures.

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