Controlled hypotension with nitroglycerin and general anesthesia during transurethral resection of the prostate

Abstract

In this prospective trial the effects of controlled hypotension with nitroglycerin during transurethral resection of the prostate (TURP) on blood loss, operating time and postoperative catheter removal time were studied. General anaesthesia with controlled hypotension (GACH) was used in 15 patients; other 15 patients received only general anaesthesia (GA) and another 15 had epidural anaesthesia (EA). The mean time of resection under GACH (37 ± 3 mins) was shorter than those of EA (40 ± 3 mins) and only GA (41 ± 3 mins), but these differences were not statistically significant (p>0.05). The resected tissue for each minute in the group received GACH (0.71 g/min) was significantly higher than those of the groups had only GA (0.54 g/min) and EA (0.43 g/min). Although mean blood loss per gram of resected tissue in the group received GACH was 21 ± 2 ml, these were found as 39 ± 3 ml and 48.3 ml in CA and EA groups respectively (p<0.05). In GACH group catheter was removed earlier than the others (3.3 days versus 4.4 and 5.6 days respectively). As a result, we conclude that GACH can be preferred in hypertensive patients with stable cardiac status undergoing TURP for benign prostatic enlargement.