Spinal Anaesthesia for Hysteroscopic Myomectomy: Efficacy and Safety in a Fertility Hospital in South-South, Nigeria

Background: Submucosal uterine fibroids are a leading cause of abnormal uterine bleeding and infertility in women of reproductive age. Hysteroscopic myomectomy has emerged as a minimally invasive, uterus-sparing technique for their management. Aim: This study evaluates the efficacy and safety of spinal anaesthesia for hysteroscopic myomectomy performed over four years in a busy private health facility in Port Harcourt, Nigeria. Methods: A retrospective review was conducted on 150 women who underwent hysteroscopic myomectomy between January 2019 and December 2023. Data were extracted on demographics, indications, intraoperative parameters postoperative complications, hospital stay, analgesic requirements, and Descriptive statistics were used to summarise the findings. Results: The mean age of patients was 39.3 ± 6.2 years. Abnormal uterine bleeding (53.3%) and pelvic pain (36.7%) were the most common indications. Spinal anaesthesia using 10mg heavy bupivacaine with 25micrograms of fentanyl was administered in all the cases, and the mean fluid deficit remained below 1000 mL in all cases. No major anaesthetic complications except pruritus from glycine and or fentanyl. All patients were discharged within three days. Conclusion: Hysteroscopic myomectomy, supported by careful anaesthetic planning and perioperative management, is a safe and effective option for the treatment of submucosal fibroids. This study affirms its feasibility and favourable outcomes in resource-constrained settings, advocating for its broader adoption in similar environments. Keywords: Spinal Anaesthesia, Hysteroscopic Myomectomy, Submucosal Fibroids.