A randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasiaReport as inadecuate




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BMC Anesthesiology

, 10:7

First Online: 28 May 2010Received: 04 December 2009Accepted: 28 May 2010

Abstract

BackgroundCentral nervous system changes, circulatory and electrolyte imbalances are the main complications of endoscopic transurethral resection of the prostate TURP which is known as transurethral resection TUR syndrome, which occurs as result of excessive absorption of irrigating fluid. We compare glycine 1.5% versus glucose 5% and normal saline 0.9% as irrigating solutions during TURP in patients with moderate to severe bladder outlet obstruction due to benign prostatic hyperplasia BPH.

MethodsThree hundred sixty patients with symptomatic BPH were randomized into a prospective, controlled trial comparing the three irrigation modalities. One-hundred twenty patients used glycine 1.5% solution as irrigating fluid glycine group, 120 patients used glucose 5% solution glucose group and 120 patients used normal saline 0.9% solution saline group. Patient-s demographics, operation time, hospital stay, postoperative amino acid glycine assay, postoperative serum cardiac troponin I and perioperative complications were noted.

ResultsNo difference was found between the groups in the immediate postoperative levels of hemoglobin and hematocrite. A high glycine level was associated with the TUR syndrome. Seventeen patients had TUR syndrome; all were in glycine group and they had the highest postoperative amino acid glycine levels. Slight increase in serum sodium 142.6 ± 12.6 mmol-l was detected in saline group. Transient Hyperglycemia 170 ± 35.9 mg-dl and hypokalemia 3.67 ± 0.92 mmol-l occurred in the immediate postoperative period in the glucose group.

ConclusionEndoscopic TURP performed using either glucose 5% or saline 0.9% irrigating solution during and after surgery is associated with lower incidence of TUR syndrome, lower catheterization period, shorter hospital stay and no cardiac toxicity in comparison with glycine 1.5% solution.

Trial RegistrationThis clinical trail had been approved and registered in PACT Registry; with identification number for the registry is ATMR2010010001793131.

AbbreviationsTURPTransurethral resection of the prostate

CVPCentral venous pressure

TUR SyndromeTransurethral resection syndrome

HRHeart rate

BPHBenign prostatic hyperplasia

PSAProstatic specific antigen

C Tn ICalcium troponin I

ECGElectrocardiogram

MABPMean arterial blood pressure.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2253-10-7 contains supplementary material, which is available to authorized users.

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Author: Ayman A Yousef - Ghada A Suliman - Osama M Elashry - Mahmoud D Elsharaby - Abd El-naser K Elgamasy

Source: https://link.springer.com/







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