Comparison of hemodynamic profiles in transurethral resection of prostate vs transurethral resection of urinary bladder tumors during spinal anesthesia

a bioimpedance study

Tiberiu Ezri, Nidal Issa, Deeb Zabeeda, Benjamin Medalion, Alexander Tsivian, Reuven Zimlichman, Peter Szmuk, Shmuel Evron

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Study Objective: Transurethral resection of prostate (TURP) is more frequently associated with perioperative fluid and electrolyte disturbances than transurethral resection of bladder tumors (TURT) because of irrigating fluid absorption. Because fluid overload may cause hypertension, we compared the patients' intraoperative hemodynamic profiles (including the incidence of hypertension) during TURP vs TURT, both performed during spinal anesthesia, by using the bioimpedance method. Design: Prospective single-blind study. Setting: University hospital. Patients: 80 (40 in each group) men, ASA physical status I and II. Interventions: Patients underwent TURP or TURT surgery with spinal anesthesia. Measurements: Mean arterial pressure, heart rate, cardiac index, and systemic vascular resistance were compared between the 2 groups. A mean arterial pressure greater than 30% from the baseline value was considered as hypertension. Plasma sodium was measured preoperatively, intraoperatively, and postoperatively. Main Results: Transurethral resection of prostate patients received more irrigating fluid (7900 ± 2310 vs 5650 ± 21 560, P < 0.05) and had a higher calculated volume of fluid absorbed: 638 ± 60 vs 303 ± 40 mL for the TURT patients (P < 0.05). Mean arterial pressures were higher with TURP, 30 minutes after the onset of surgery and at the end of the procedure (111 ± 15 vs 100 ± 10 and 109 ± 14 vs 99 ± 14 mmHg, respectively; P < 0.05). However, there was no hypertension in either group. There were no differences in hemodynamic measurements of hyponatremic vs normonatremic patients. Plasma sodium decreased postoperatively more in the TURP group (140.4 ± 2.6 mEq/L baseline to 134.1 ± 3.5 mEq/L, P < 0.05) and was lower postoperatively in the TURP group compared with TURT (134.1 ± 3.5 vs 137.2 ± 2.9 mEq/L, P = 0.04). Conclusions: Although more irrigating fluid was absorbed in the TURP group, there were no episodes of hypertension in either group.

Original languageEnglish (US)
Pages (from-to)245-250
Number of pages6
JournalJournal of Clinical Anesthesia
Volume18
Issue number4
DOIs
StatePublished - Jun 2006

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Transurethral Resection of Prostate
Spinal Anesthesia
Urinary Bladder Neoplasms
Urinary Bladder
Hemodynamics
Hypertension
Arterial Pressure
Sodium
Single-Blind Method
Vascular Resistance
Electrolytes
Heart Rate
Incidence

Keywords

  • Cardiac output
  • Hemodynamics
  • Hypertension
  • Thoracic bioimpedance
  • TURP
  • TURT

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Comparison of hemodynamic profiles in transurethral resection of prostate vs transurethral resection of urinary bladder tumors during spinal anesthesia : a bioimpedance study. / Ezri, Tiberiu; Issa, Nidal; Zabeeda, Deeb; Medalion, Benjamin; Tsivian, Alexander; Zimlichman, Reuven; Szmuk, Peter; Evron, Shmuel.

In: Journal of Clinical Anesthesia, Vol. 18, No. 4, 06.2006, p. 245-250.

Research output: Contribution to journalArticle

Ezri, Tiberiu ; Issa, Nidal ; Zabeeda, Deeb ; Medalion, Benjamin ; Tsivian, Alexander ; Zimlichman, Reuven ; Szmuk, Peter ; Evron, Shmuel. / Comparison of hemodynamic profiles in transurethral resection of prostate vs transurethral resection of urinary bladder tumors during spinal anesthesia : a bioimpedance study. In: Journal of Clinical Anesthesia. 2006 ; Vol. 18, No. 4. pp. 245-250.
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AU - Zabeeda, Deeb

AU - Medalion, Benjamin

AU - Tsivian, Alexander

AU - Zimlichman, Reuven

AU - Szmuk, Peter

AU - Evron, Shmuel

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N2 - Study Objective: Transurethral resection of prostate (TURP) is more frequently associated with perioperative fluid and electrolyte disturbances than transurethral resection of bladder tumors (TURT) because of irrigating fluid absorption. Because fluid overload may cause hypertension, we compared the patients' intraoperative hemodynamic profiles (including the incidence of hypertension) during TURP vs TURT, both performed during spinal anesthesia, by using the bioimpedance method. Design: Prospective single-blind study. Setting: University hospital. Patients: 80 (40 in each group) men, ASA physical status I and II. Interventions: Patients underwent TURP or TURT surgery with spinal anesthesia. Measurements: Mean arterial pressure, heart rate, cardiac index, and systemic vascular resistance were compared between the 2 groups. A mean arterial pressure greater than 30% from the baseline value was considered as hypertension. Plasma sodium was measured preoperatively, intraoperatively, and postoperatively. Main Results: Transurethral resection of prostate patients received more irrigating fluid (7900 ± 2310 vs 5650 ± 21 560, P < 0.05) and had a higher calculated volume of fluid absorbed: 638 ± 60 vs 303 ± 40 mL for the TURT patients (P < 0.05). Mean arterial pressures were higher with TURP, 30 minutes after the onset of surgery and at the end of the procedure (111 ± 15 vs 100 ± 10 and 109 ± 14 vs 99 ± 14 mmHg, respectively; P < 0.05). However, there was no hypertension in either group. There were no differences in hemodynamic measurements of hyponatremic vs normonatremic patients. Plasma sodium decreased postoperatively more in the TURP group (140.4 ± 2.6 mEq/L baseline to 134.1 ± 3.5 mEq/L, P < 0.05) and was lower postoperatively in the TURP group compared with TURT (134.1 ± 3.5 vs 137.2 ± 2.9 mEq/L, P = 0.04). Conclusions: Although more irrigating fluid was absorbed in the TURP group, there were no episodes of hypertension in either group.

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