Anaesthetic management of transurethral resection of prostate in a patient with aortic and mitral valve replacement

Regional anesthesia in transurethral resection of prostate (TURP) surgery: A comparative study between saddle block and subarachnoid block

Background:

Spinal anesthesia is the technique of choice in transurethral resection of prostate (TURP). The major complication of spinal technique is risk of hypotension. Saddle block paralyzed pelvic muscles and sacral nerve roots and hemodynamic derangement is less.

Aims and objectives:

To compare the hemodynamic changes and adequate surgical condition between saddle block and subarachnoid block for TURP.

Material and methods:

Ninety patients of aged between 50 to 70 years of ASA-PS I, II scheduled for TURP were randomly allocated into 2 groups of 45 in each group. Group A patients were received spinal (2 ml of hyperbaric bupivacaine) and Group B were received saddle block (2 ml of hyperbaric bupivacaine). Baseline systolic, diastolic and mean arterial pressure, heart rate, oxygen saturation were recorded and measured subsequently. The height of block was noted in both groups. Hypotension was corrected by administration of phenylephrine 50 mcg bolus and total requirement of vasopressor was noted. Complications (volume overload, TURP syndrome etc.) were noted.

Results:

Incidence of hypotension and vasopressor requirement was less (P < 0.01) in Gr B patients. Adequate surgical condition was achieved in both groups. There was no incidence of volume overload, TURP syndrome, and bladder perforation.

Conclusion:

TURP can be safely performed under saddle block without hypotension and less vasopressor requirement.