Derya ÖZKAN, Jülide ERGİL, Mustafa ÖZMEN, Fulya MENDEŞ, Haluk GÜMÜŞ

Spinal anestezi altinda gelişen transüretral prostat rezeksiyonu (tur-p) sendromu

Transüretral prostat rezeksiyonu sendromu (TUR-P), yüksek hacimde kullanılan irigasyon sıvısının absorbsiyonunun neden olduğu, intravasküler hacim ve plazma elektrolit konsantrasyonlarındaki hızlı değişimlere bağlı gelişen, kalp-dolaşım sistemi ve nörolojik problemlerle karakterize bir sendromdur. Bu sunumda, spinal anestezi-sedasyon uygulanan bir hastada gelişen TUR-P sendromu nedeniyle sendromu yeniden gözden geçirmek istedik.

Transurethral resectıon of the prostate (tur-p) syndrome due

Transurethral resection of the prostate (TUR-P) syndrome is characterized by cardiocirculatory and neurological problems due to rapid changes in intravascular volume and plasma electrolyte concentrations caused by the absorption of the excessive used irrigation fluids. In this paper, we revized the TUR-P syndrome in a patient who received spinal anesthesia-sedation.

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1. Siddiqui MA, Berns JS, Baime MJ. Glycine irrigant absorption syndrome following cystoscopy. Clin Nephrol 1996; 45: 365-6.
2. Gehring H, Nahm W, Zimmermann K, Fornara P, Ocklitz E, Schmucker P. Irrigating fluid absorption during percutaneous nephrolithotripsy. Acta Anaesthesiol Scand 1999; 43: 316-21.
3. Ichai C, Ciais JF, Roussel LJ, et al. Intravascular absorption of glycine irrigating solution during shoulder arthroscopy: a case report and follow-up study. Anesthesiology 1996; 85: 1481-5.
4. Hurlbert BJ, Wingard DW. Water intoxication after 15 minutes of transurethral resection of the prostate. Anesthesiology 1979: 50: 355-6.
5. Swaminathan R, Tormey WP. Fluid absorption during transurethral prostatectomy [letter]. Br Med J 1981; 282: 317.
6. Ramsay MA, Savege TM, Simpson BR, Goodwin R. Controlled sedation with alphaxalone-alphadolone. Br Med J 1974; 2: 656-9.
7. Hahn RG. Fluid absorption in endoscopic surgery. Br J Anaesth 2006; 96: 8-20.
8. Olsson J, Nilsson A, Hahn RG. Symptoms of the transurethral resection syndrome using glycine as the irrigant. J Urol 1995; 154: 123-8.
9. Hatch PD. Surgical and anaesthetic considerations in transurethral resection of the prostate. Anaesth Intensive Care 1987; 15: 203-11.
10. Marx GF, Orkin LR. Complications associated with transurethral surgery. Anesthesiology 1962; 23: 802-13.
11. Henderson DJ, Middleton RG. Coma from hyponatremia following transurethral resection of the prostate. Urology 1980; 15: 267-71.
12. Jensen V. The TURP syndrome. Can J Anaesth 1991; 38: 90-6.
13. Hahn RG, Nilsson A, Farahmand BY, Ekengren J, Persson PG. Operative factors and long-term incidence of acute myocardial infarction after transurethral resection of the prostate. Epidemiology 1996; 7: 93-5.
14. Kay MC, Kay J, Begun F, Yeung JE. Vision loss following transurethral resection of the prostate. J Clin Neuroophthalmol 1985; 5; 273-6.
15. Creel DJ, Wang JM, Wong KC. Transient blindness associated with transurethral resection of the prostate. Arch Ophthalmol 1987; 105: 1537-9.
16. Hahn RG, Ekengren JC. Patterns of irrigating fluid absorption during transurethral resection of the prostate as indicated by ethanol. J Urol 1993; 149: 502-6.
17. Mebust WK, Holtgrewe HL, Cockett AT, Peters PC. Transurethral prostatectomy: immediate and postoperative complications. Cooperative study of 13 participating institutions evaluating 3.885 patients. J Urol 1989; 141: 243-7.
18. Edwards ND, Callaghan LC, White T, Reilly CS. Perioperative myocardial ischaemia in patients undergoing transurethral surgery: a pilot study comparing general with spinal anaesthesia. Br J Anaesth 1995; 74: 368-72.
19. Azar I. Transurethral prostatectomy syndrome and other complications of urological procedures. In: McLeskey CH, ed. Geriatric Anaesthesiology. Baltimore, Williams & Wilkins 1997; 595-607.
20. Gehring H, Nahm W, Baerwald J, et al. Irrigation fluid absorpti- on during transurethral resection of the prostate: spinal vs. general anaesthesia. Acta Anaesthesiol Scand 1999; 43: 458-63.
21. Hawary A, Mukhtar K, Sinclair A, Pearce I. Transurethral resection of the prostate syndrome: almost gone but not forgotten. J Endourol 2009; 23: 2013-20.
22. Munn J. TURP syndrome. In: Allman K, Wilson I, eds. Oxford Handbook of Anaesthesia 2nd ed. Oxford UK, Oxford University Press 2006, 570-1.
23. Ayus JC, Arieff AI. Glycine-induced hypo-osmolar hyponatremia. Arch Intern Med 1997; 157: 223-6.