COMPARISON OF ARTERIAL PRESSURE AND VASOPRESSOR (PHENYLEPHRINE) AMONG PATIENTS UNDERGOING TURP WITH SPINAL ANESTHESIA VERSUS SADDLE BLOCK

Authors

  • HFU ISLAM 1Department of Anaesthesia & ICU, Services Hospital Lahore, Pakistan
  • M ASIF Department of Anesthesia, Services Hospital Lahore, Pakistan
  • A ABBAS Department of Anaesthesia and pain management, Jinnah hospital Lahore, Pakistan
  • MU JAHANGIR Department of Anaesthesia and ICU, Mubarak Al-Kabeer Hospital, Kuwait
  • N NAJIB Department of Anatomy, Al-Aleem Medical College, Pakistan
  • MO SIDDIQUE Department of Anesthesia and Critical Care, Jinnah Hospital Lahore
  • A FARAZ Department of Accident and Emergency Shaikh Zayed Hospital Lahore, Pakistan
  • F ASHFAQ Department of General Surgery and Surgical Oncology, Shaikh Zayed Lahore, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.520

Keywords:

Transurethral Resection of Prostate (TURP), Benign Prostatic Hyperplasia (BPH), Spinal Anesthesia, Saddle block, Vasopressor, arterial pressure

Abstract

Transurethral Resection of Prostate (TURP) is a common procedure for treating Benign Prostatic Hyperplasia (BPH) in elderly males. Spinal Anesthesia is conventionally used during the procedure; however, some studies have preferred saddle block regarding the average time of induction requirement for vasopressors.  This study compared the mean change in mean arterial pressure and the mean vasopressor requirement (phenylephrine) among patients undergoing TURP with spinal anesthesia versus Saddle block. This randomized controlled trial was conducted at the Anesthesia Department, Jinnah Hospital Lahore, for Six months on 120 cases (group 1: 60, group 2: 60) of male patients aged 40-80 years undergoing TURP surgery. Patients in Group A received 2 ml of 0.75% bupivacaine and were placed supine with one pillow, while Group B received 2 ml of hyperbaric 0.75% in the same manner as Group A but remained in the sitting position for 10 minutes and then made supine with one pillow under the head. Demographic and clinical data was entered and analyzed using SPSS. Mean, Standard Deviation, Frequency, and percentages were calculated for quantitative and qualitative data, respectively, and an independent sample t-test was used for mean differences, keeping p-value<0.05 as significant. The mean age in the Spinal anesthesia group was 61.23 ± 12.06 years, while the mean age in the Saddle block group was 59.55 ± 11.57 years. In the Spinal and Saddle block, the mean arterial pressure before the procedure was 102.60 ± 5.33 and 95.52 ± 4.52, respectively. The mean change in MAP in the spinal group was 20.02 ± 5.76, and in the Saddle block group was 10.95 ± 5.93. The mean vasopressor requirement in Spinal anesthesia was 102.18 ± 19.17, and in Saddle block was 30.67 ± 26.46, respectively. All measures showed significantly lower mean change in Saddle block groups, p-value < 0.05 for all. This study's findings concluded that the mean change in mean arterial pressure and Vasopressor (phenylephrine) requirement among patients undergoing TURP Saddle block was favorable. So, TURP can be safely performed under saddle block without hypotension and less vasopressor requirement.

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References

Bamigboye, J., Olateju, S., Faponle, A., and Salako, A. (2021). Saddle Block for Transrectal Prostate Biopsy: A Comparison of the Analgesic Efficacy of 0.25% Bupivacaine and 0.375% Ropivacaine. Annals of Health Research 7, 292-301.

Bhattacharyya, S., Bisai, S., Biswas, H., Tiwary, M. K., Mallik, S., and Saha, S. M. (2015). Regional anesthesia in transurethral resection of prostate (TURP) surgery: A comparative study between saddle block and subarachnoid block. Saudi Journal of Anaesthesia 9, 268.

Bilhim, T., Costa, N. V., Torres, D., Pinheiro, L. C., and Spaepen, E. (2022). Long-term outcome of prostatic artery embolization for patients with benign prostatic hyperplasia: single-centre retrospective study in 1072 patients over a 10-year period. CardioVascular and Interventional Radiology 45, 1324-1336.

Csikós, E., Horváth, A., Ács, K., Papp, N., Balázs, V. L., Dolenc, M. S., Kenda, M., Kočevar Glavač, N., Nagy, M., and Protti, M. (2021). Treatment of benign prostatic hyperplasia by natural drugs. Molecules 26, 7141.

De Nunzio, C., Salonia, A., Gacci, M., and Ficarra, V. (2020). Inflammation is a target of medical treatment for lower urinary tract symptoms associated with benign prostatic hyperplasia. World journal of urology 38, 2771-2779.

Devlin, C. M., Simms, M. S., and Maitland, N. J. (2021). Benign prostatic hyperplasia–what do we know? BJU international 127, 389-399.

Foo, K. T. (2019). What is a disease? What is the disease clinical benign prostatic hyperplasia (BPH)? World journal of urology 37, 1293-1296.

Huang, S.-W., Tsai, C.-Y., Tseng, C.-S., Shih, M.-C., Yeh, Y.-C., Chien, K.-L., Pu, Y.-S., and Tu, Y.-K. (2019). Comparative efficacy and safety of new surgical treatments for benign prostatic hyperplasia: systematic review and network meta-analysis. bmj 367.

Jiang, Y.-L., and Qian, L.-J. (2019). Transurethral resection of the prostate versus prostatic artery embolization in the treatment of benign prostatic hyperplasia: a meta-analysis. BMC urology 19, 1-8.

Kim, Y. H., Kwon, S. Y., Jun, E. H., Choi, S. T., Park, S. J., and Kim, Y. (2021). Comparison of epidural, spinal, and saddle block for holmium laser enucleation of prostate (HoLEP): A prospective randomized, comparative study. Medicine 100.

Kshetrapal, K., Mishra, P., Kamal, H., and Bansal, P. (2021). Is Saddle block superior to spinal anaesthesia for patients undergoing transurethral resection of prostate-a comparative evaluation. Asian Journal of Medical Sciences 12.

Langan, R. C. (2019). Benign prostatic hyperplasia. Primary Care: Clinics in Office Practice 46, 223-232.

Launer, B. M., McVary, K. T., Ricke, W. A., and Lloyd, G. L. (2021). The rising worldwide impact of benign prostatic hyperplasia. BJU international 127, 722-728.

Lokeshwar, S. D., Harper, B. T., Webb, E., Jordan, A., Dykes, T. A., Neal Jr, D. E., Terris, M. K., and Klaassen, Z. (2019). Epidemiology and treatment modalities for the management of benign prostatic hyperplasia. Translational andrology and urology 8, 529.

Moosavi Tekya, S., Sharifian Atar, A., and Asgharian, N. (2006). The selection of the regional anesthesia in the transuretheral resection of the prostate (TURP). Internal Medicine Today 11, 42-48.

Özmen, S., Koşar, A., Soyupek, S., Armağan, A., Hoşcan, M., and Aydin, C. (2003). The selection of the regional anaesthesia in the transurethral resection of the prostate (TURP) operation. International Urology and Nephrology 35, 507-512.

Parsons, J. K., Dahm, P., Köhler, T. S., Lerner, L. B., and Wilt, T. J. (2020). Surgical management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline amendment 2020. The Journal of urology 204, 799-804.

Picel, A. C., Hsieh, T.-C., Shapiro, R. M., Vezeridis, A. M., and Isaacson, A. J. (2019). Prostatic artery embolization for benign prostatic hyperplasia: patient evaluation, anatomy, and technique for successful treatment. Radiographics 39, 1526-1548.

Rastrelli, G., Vignozzi, L., Corona, G., and Maggi, M. (2019). Testosterone and benign prostatic hyperplasia. Sexual medicine reviews 7, 259-271.

Sivasankari, M. (2020). A Comparative study of Intrathecal Low Dose Bupivacaine with Fentanyl and Low Dose Levobupivacaine with Fentanyl in Transurethral Resection of Prostate, Tirunelveli Medical College, Tirunelveli.

Vickman, R. E., Franco, O. E., Moline, D. C., Vander Griend, D. J., Thumbikat, P., and Hayward, S. W. (2020). The role of the androgen receptor in prostate development and benign prostatic hyperplasia: A review. Asian journal of urology 7, 191-202.

Zhang, W., Cao, G., Sun, Y., Wu, F., Wang, Q., Xu, T., Hu, H., and Xu, K. (2022). Depressive symptoms in individuals diagnosed with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) in middle-aged and older Chinese individuals: Results from the China Health and Retirement Longitudinal Study. Journal of Affective Disorders 296, 660-666.

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Published

2023-11-06

How to Cite

ISLAM, H., ASIF, M., ABBAS, A., JAHANGIR, M., NAJIB, N., SIDDIQUE, M., FARAZ, A., & ASHFAQ, F. (2023). COMPARISON OF ARTERIAL PRESSURE AND VASOPRESSOR (PHENYLEPHRINE) AMONG PATIENTS UNDERGOING TURP WITH SPINAL ANESTHESIA VERSUS SADDLE BLOCK. Biological and Clinical Sciences Research Journal, 2023(1), 520. https://doi.org/10.54112/bcsrj.v2023i1.520

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