Recommended Suction Pressure for Dilation and Curettage
For suction dilation and curettage procedures, the recommended suction pressure is 80-100 mmHg, which provides adequate vacuum for efficient removal of tissue while minimizing risk of complications. 1
Suction Pressure Guidelines
- Suction pressure of 80-100 mmHg is typically used for pediatric patients and is appropriate for most D&C procedures 1
- The vacuum delivered to the tip of the suction catheter varies based on multiple factors including:
- Viscosity of tissue/secretions
- Length and diameter of tubing
- Size of the collection bottle 1
- The pressure should be adequate to efficiently remove tissue with a rapid pass of the catheter 1
Catheter Selection and Technique
- Use the largest size catheter that will fit inside the uterine cavity for most efficient tissue removal 1
- Apply suction both while inserting and removing the catheter for optimal tissue collection 1
- Complete the suction procedure rapidly (within 5 seconds when possible) to minimize complications 1
Special Considerations
- For procedures involving pregnancy tissue, a negative pressure of 600 mmHg (or -80 kPa) has been used successfully in combined surgical abortion and laparoscopic sterilization procedures 2
- Higher blood loss (≥200mL) during D&C is associated with:
- Higher BMI
- Greater gestational age
- Procedures performed in operating room settings versus clinic settings 3
Potential Complications and Precautions
- Excessive vacuum pressure (above 80-120 mmHg) increases the likelihood of mucosal damage and does not increase efficiency of tissue removal 1
- For open suction procedures in different clinical contexts, safe and effective pressures have been established as:
- 80-120 mmHg for low-viscosity material
- 150 mmHg for medium-viscosity material
- 200 mmHg for high-viscosity material 4
- When using suction devices, ensure the machine can generate adequate vacuum to efficiently suction in a few seconds 1
- Verify the suction equipment is functioning properly before beginning the procedure 1
Equipment Considerations
- A properly sized suction device with an adjustable suction regulator should be available 1
- For thoracoscopic procedures involving blood clot removal, intermittent variable suction between zero and 60 mmHg has been used successfully 5
- Studies have shown that healthcare providers often set suction pressures higher than recommended levels when objective measurement tools are not visible 6