1708
document
Effect of spinal versus general anesthesia on bladder compliance and intraabdominal pressure during transurethral procedures . 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 .
1709
Intervention_Physical
spinal versus general anesthesia
1710
Intervention_Physical
spinal versus general anesthesia
1711
Intervention_Surgical
transurethral surgery .
1712
Intervention_Pharmacological
hyperbaric tetracaine
1713
Intervention_Physical
General Anesthesia ( GA )
1714
Intervention_Pharmacological
fentanyl intravenous
1715
Intervention_Pharmacological
anesthesia
1716
Intervention_Pharmacological
anesthesia
1717
Intervention_Pharmacological
isoflurane
1718
Intervention_Pharmacological
nitrous oxide ( N2O ) in oxygen
1719
Intervention_Physical
anesthesia
1720
Intervention_Physical
spinal and general anesthesia
1721
Intervention_Physical
spinal anesthesia
1722
Outcome_Physical
bladder compliance
1723
Outcome_Physical
intraabdominal pressure
1724
Outcome_Physical
bladder compliance
1725
Outcome_Physical
intraabdominal pressure
1726
Outcome_Physical
intraabdominal pressure
1727
Outcome_Physical
mean intraabdominal pressure
1728
Outcome_Physical
bladder compliance
1729
Participant_Age
elderly
1730
Participant_Sex
males
1731
Participant_Condition
undergoing elective transurethral resection of the prostate
1732
Participant_Sample-size
21
1733
Participant_Condition
ASA physical status I , II , and III patients
1734
Participant_Age
at least 18