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A 33-year-old nulligravid woman is undergoing hysteroscopic removal of a 5 cm FIGO type 1 submucosal myoma due to heavy menstrual bleeding and mild anemia. She is otherwise in good health and has no significant medical or surgical history. She is not on any medications and denies drug allergy. The patient receives general anesthesia without difficulty. The procedure commences with use of a fluid management system and a bipolar resectoscope to remove myoma fragments. Approximately 30 minutes into the surgery, the anesthesiologist becomes concerned due to sudden decrease of oxygen saturation to 87%. The total fluid deficit is approaching 2300 mL. The anesthesiologist administers intravenous (IV) furosemide and asks the surgeon to terminate the procedure. Several minutes later, oxygen saturations increase to 92%. The patient is awakened from anesthesia and proceeds to the recovery room in a stable condition.
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