Haemodynamic and haemostatic alterations in TUR-P patients undergoing epidural, spinal, and general anaesthesia Epidural, spinal ve genel anestezi uygulanan TUR-P olgularinda hemodinamik ve hemostatik degisiklikler
Turk Anesteziyoloji ve Reanimasyon, cilt.25, sa.8, ss.367-372, 1997 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 25 Sayı: 8
- Basım Tarihi: 1997
- Dergi Adı: Turk Anesteziyoloji ve Reanimasyon
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.367-372
- Anahtar Kelimeler: Epidural anaesthesia, General anaesthesia, Haemodynamic, Haemostatic, Spinal anaesthesia, Tur- p
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
We have compared the haemodynamic and haemostatic changes before and during transuretral resection of the prostate in 45 patients under general, spinal or epidural anaesthesia. The patients were randomly divided into 3 groups. Group I (n=15) received general anaesthesia, with 60% N2O and 1-2% halothane in O2. Group II (n=15) received spinal anaesthesia with 0.5% bupivacaine. Group III (n=15) received epidural anaesthesia with 0.5% bupivacaine. In the general anaesthetic group and spinal anaesthetic group, there were significant decreases in mean arterial pressure (33%, 27%) and heart rate (16%, 13%) after the start of resection to preinduction value. In the epidural anaesthetic group mean arterial pressure decreased after induction (15%), heart rate decreased 4%. There was a significant decrease in intraoperative blood loss in patients under epidural anaesthesia and spinal anaesthesia than general anaesthesia. Measured indices of coagulation, platelet agregation and fibrinolysis (such as; prothrombin time, activated partial thromboplastin time, fibrinogen level) showed no abnormalities compared with the control values in three groups. However, there was a significant decrease in alpha -2 antiplazmin during surgery in the general anaesthetic group suggests an increase in fibrinolytic activity. Our study suggests that epidural anaesthesia during transurethral resection of the prostate is superior to general and spinal anaesthesia because of inhibitory effect on platelet agregation and hemodynamic stability.