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Continuing Education in Anaesthesia, Critical Care & Pain Advance Access originally published online on May 4, 2009
Continuing Education in Anaesthesia, Critical Care & Pain 2009 9(3):92-96; doi:10.1093/bjaceaccp/mkp012
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© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Anaesthesia for transurethral resection of the prostate

Aidan M. O'Donnell, BSc MB ChB FRCA
Consultant Anaesthetist
St John's Hospital at Howden
Howden Road West
Livingston EH54 6PP, UK

Irwin T.H. Foo, MB BChir MD MRCP(UK) FRCA
Consultant Anaesthetist
Western General Hospital
Crewe Road South
Edinburgh EH4 2XU, UK
Tel: +44 131 537 1651
Fax: +44 131 537 1025
E-mail: irwin.foo@luht.scot.nhs.uk (for correspondence)

The first 150 words of the full text of this article appear below.


Key points

Spinal anaesthesia is considered to be the technique of choice for TURP.
TURP syndrome comprises the effects produced by rapid changes in osmolality and circulating volume, together with the effects of glycine, caused by the absorption of glycine 1.5%.
In TURP syndrome, hypoosmolality is more important than hyponatraemia in causing central nervous system disturbances.
TURP syndrome treatment can be divided into management of volume changes and management of solute changes (hyponatraemia, hypoosmolality, and direct toxicity of irrigation fluid used).
Newer techniques of transurethral prostatic resection promise a reduced risk of TURP syndrome.

 

Approximately 40 000 transurethral resections of the prostate (TURP) are performed annually in the UK. TURP remains the surgical gold standard for the treatment of benign prostatic hyperplasia (BPH), which causes urinary obstruction and increases the risk of urinary tract infection. Perioperative morbidity from this procedure ranges between 18% and 26% and the mortality rate may . . . [Full Text of this Article]


   Relevant anatomy
 

   Surgical technique
 

   Irrigation fluid
 

   Patient group
 

   Choice of anaesthetic technique
 
Spinal anaesthesia

General anaesthesia

Local anaesthesia


   Potential intraoperative problems
 

   Potential postoperative problems
 

   Haemorrhage
 

   TURP syndrome
 
Volume changes

Solute changes

Glycine and its metabolites

Treatment


   Newer techniques of prostatic resection
 

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