Document Detail


Effect of spinal versus general anesthesia on bladder compliance and intraabdominal pressure during transurethral procedures.
MedLine Citation:
PMID:  10470636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To evaluate the influence of spinal versus general anesthesia on bladder compliance and intraabdominal pressure in elderly males undergoing elective transurethral resection of the prostate. DESIGN: Prospective, randomized, open-label study. SETTING: Teaching hospital. PATIENTS: 21 ASA physical status I, II, and III patients at least 18 years of age, undergoing transurethral surgery. INTERVENTIONS: According to a computer-generated randomization schedule, patients were allocated to one of two groups. In Group Spinal (S), 10 mg of hyperbaric tetracaine was administered intrathecally. In Group General Anesthesia (GA), patients received, fentanyl intravenous (i.v. 1 to 2 micrograms/kg and propofol i.v. 1.0 to 2.0 mg/kg for induction of anesthesia. Thereafter, a laryngeal mask airway was inserted and, with spontaneous ventilation, anesthesia was maintained by administering isoflurane (end-tidal 0.7% to 1.2%) and 70% nitrous oxide (N2O) in oxygen. Intraabdominal pressure and bladder compliance were recorded prior to the induction of anesthesia and immediately before the onset of the surgical procedure. MEASUREMENTS AND MAIN RESULTS: The two groups were demographically comparable. In Group S, mean bladder compliance was significantly (p = 0.003) higher and mean intraabdominal pressure significantly lower (p = 0.007) when compared to baseline preanesthetic values. In Group GA, mean intraabdominal pressure significantly (p = 0.006) decreased when compared to baseline preanesthetic recordings. Following the induction of general anesthesia, a small change in bladder compliance was noted. However, statistical significance was not reached. Data were analyzed and compared using Student's t-test (p < 0.05 was considered statistically significant). CONCLUSION: Both spinal and general anesthesia induced a significant decrease in intraabdominal pressure. While both techniques were associated with an increase in bladder compliance, statistical significance was demonstrated only in the spinal anesthesia treatment group.
Authors:
D Olsfanger; E Zohar; B Fredman; S Richter; R Jedeikin
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  11     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  1999 Jun 
Date Detail:
Created Date:  1999-10-07     Completed Date:  1999-10-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  328-31     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Intensive Care, Meir Hospital, Kfar Saba, Israel.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / physiology*
Aged
Aged, 80 and over
Anesthesia, General*
Anesthesia, Spinal*
Anesthetics, Inhalation / administration & dosage
Anesthetics, Intravenous / administration & dosage
Anesthetics, Local / administration & dosage
Fentanyl / administration & dosage
Humans
Isoflurane / administration & dosage
Laryngeal Masks
Male
Middle Aged
Nitrous Oxide / administration & dosage
Pressure
Propofol / administration & dosage
Prospective Studies
Prostatectomy / methods*
Surgical Procedures, Elective
Tetracaine / administration & dosage
Urinary Bladder / drug effects,  physiology*
Urodynamics / drug effects,  physiology*
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Anesthetics, Intravenous; 0/Anesthetics, Local; 10024-97-2/Nitrous Oxide; 2078-54-8/Propofol; 26675-46-7/Isoflurane; 437-38-7/Fentanyl; 94-24-6/Tetracaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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