Pitfalls and Problems in Anesthesia for Transurethral Resection . |
Jae Kyu Jeon, Kyu Taek Choi, Jung Kil Chung |
Department of Anesthesiology, keimyung University Medical College and Hospital, Taegu, Korea. |
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Abstract |
The anesthetist plays an important role in recognizing and managing the problems during surgery as well as postoperatively in patients having transurethral resection.
As the number of transurethral resctions increase in Korea, we are facing more cardiovascular and respiratory problems as well as other problems. During the 5year period from 1974 to 1979, 230 cases of T.U.R.'s which were performed under various anesthesia, were recorded at the Dongsan Medical Center. We have observed the problems and the pitfalls according to the following classification in table l and ll.
Underlying diseases in patients of T.U.R. , operation time, destribution of patients according to ASA classification, age and sex distribution, preoperative prolbems, classification of anesthesia and anesthetica, sedatives used during regional anesthesia and post T.U.R. complications were listed in tables lll through Xl. 1) The age of these cases ranged from 20 to 80 years old and the sixth decade was most common. 2) The preoperative problems are listed in table Vll. i.e., cardiovascular abnormalities(35.7%), pulmonary problems (10%), metabolic and endocrinenutritional disordera in that order. 3) Major underlying diseases are listed in table ll. i.e., bladder tumor, BPH and prostate carcinoma in that order of incidence. 4) Postoperative complications are listed in tabel Vll. i.e., bleeding, infection, extravasation, fluid absorption toxicity in that order of incidence. 5) The sedatives(pentothal, nembutal, valium) were used in 35.9% of the total cases during the regional analgesia for T.U.R. 6) The low spinal anesthesia is considered to be the best technique for anesthesia in T.U.R. procedures after reviewing the problems, pitfalls and complications. |
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