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Prostate anaesthetic block with ropivacaine for urologic surgery

Published online by Cambridge University Press:  13 October 2005

P. Niccolai ,
M. Carles ,
K. Lagha  and
M. Raucoules-Aimé
P. Niccolai
Affiliation:
Princesse Grace Hospital, Department of Anaesthesiology, Monte Carlo, Princedom of Monaco, France
M. Carles
Affiliation:
Nice University School of Medicine, Department of Anaesthesiology, Nice–Sophia Antipolis, France
K. Lagha
Affiliation:
Saint Antoine Hospital, Department of Urology, Nice, France
M. Raucoules-Aimé
Affiliation:
Nice University School of Medicine, Department of Anaesthesiology, Nice–Sophia Antipolis, France
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Extract

Summary

Background and objective: The aim of this study was to evaluate prostate anaesthetic block for haemodynamic tolerance and quality of analgesia during and after transurethral surgery. Methods: Ninety adult males, ASA III/IV, were randomly assigned to receive a prostate anaesthetic block (n = 45) or spinal anaesthesia (n = 45). The main outcome measurement during anaesthesia, surgery and recovery was haemodynamic tolerance (number of hypotensive episodes, heart rate, systolic and mean blood pressures). Other outcome variables were pain scores during anaesthesia, surgery and every 4 h until 24 h after the end of surgery and amount of oral morphine required during the 24-h postoperative period. Results: Sixty-six patients were ASA III and 24 ASA IV. Ongoing cardiovascular therapies were comparable between groups. All surgical procedures were performed under good conditions. For patients receiving prostate anaesthetic block, the blood pressure and heart rate did not change significantly during the study period. For patients receiving spinal anaesthesia, the hypotension rate was 55.6% (n = 25) compared to 0 in the prostate anaesthetic block group (P < 0.001); 25 and 4 patients, respectively, required vascular filling and additional ephedrine administration. In both groups, all pain scores were <40 (100 mm visual analogue scale) during the study period. Oral morphine was given during the postoperative period to two prostate anaesthetic block patients and four who had received spinal anaesthesia (not significant). Conclusion: Transurethral surgery under prostate anaesthetic block is safe and assures adequate analgesia during and after surgery.

Keywords

NERVE BLOCK, prostateANAESTHESIA, SPINALlocal ANAESTHETICS LOCAL, ropivacaineUROLOGIC SURGICAL PROCEDURES, MALE
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 11 , November 2005 , pp. 864 - 869
Copyright
© 2005 European Society of Anaesthesiology

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References

Tabet BG, Levine S. Nerve block in prostate surgery. J Urol 1996; 156: 1659–1661.Google Scholar
Steen PA, Tinker JH, Tarhan S. Myocardial infarction after anaesthesia and surgery. JAMA 1978; 239: 2566–2570.Google Scholar
Edwards ND, Callaghan LC, White T, Reilly CS. Peri-operative myocardial ischaemia in patients undergoing transurethral surgery: a pilot study comparing general with spinal anaesthesia. Br J Anaesth 1995; 74: 368–372.Google Scholar
Chernik DA, Gillings D, Laine H. Validity and reliability of the Observer's Assessment of Alertness/Sedation Scale: study with intravenous midazolam. J Clin Psychopharmacol 1990; 15: 244–251.Google Scholar
Buggy D, Higgins P, Moran C, O'Brien D, O'Donovan F, McCarroll M. Prevention of spinal anesthesia-induced hypotension in the elderly: comparison between preanesthetic administration of crystalloids, colloids, and no prehydration. Anesth Analg 1997; 84: 106–110.Google Scholar
Moore DC, Bridenbaugh LD. Spinal (subarachnoid) block. A review of 11,574 cases. JAMA 1995; 195: 123–128.Google Scholar
Coe AJ, Revanas B. Is crystalloid preloading useful in spinal anaesthesia in the elderly? Anaesthesia 1990; 45: 241–243.Google Scholar
Critchley LAH. Hypotension, subarachnoid block and the elderly patient. Anaesthesia 1996; 51: 1139–1143.Google Scholar
McCrae AF, Wildsmith JAW. Prevention and treatment of hypotension during central neural block. Br J Anaesth 1993; 70: 672–680.Google Scholar
Sinha B, Haikel G, Lange PH, Moon TD, Narayan P. Transurethral resection of the prostate with local anesthesia in 100 patients. J Urol 1986; 135: 719–721.Google Scholar
Issa MM, Ritenour C, Greenberger M, Hollabaugh Jr R, Steiner M. The prostate anesthetic block of outpatient prostate surgery. World J Urol 1998; 16: 378–383.Google Scholar
Orandi A. Urological endoscopic surgery under local anesthesia: a cost-reducing idea. J Urol 1984; 132: 1146–1147.Google Scholar
Zlotta AR, Schulman CC. Interstitial laser coagulation for the treatment of benign prostatic hyperplasia using local anesthesia only. BJU Int 1999; 83: 341–342.Google Scholar
Issa MM, Stein B, Benson R, Knoll LD, Fay R. Prospective multicenter study of transperineal prostatic block for transurethral needle ablation of the prostate. Urology 2000; 56: 1052–1055.Google Scholar