a randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia随机对比三种类型的灌溉流体在良性前列腺增生经尿道.pdfVIP

Yousef et al. BMC Anesthesiology 2010, 10:7 /1471-2253/10/7 R E S E A R C H A R T I C L E Open Access Research article A randomized comparison between three types of irrigating fluids during transurethral resection in benign prostatic hyperplasia Ayman A Yousef*, Ghada A Suliman, Osama M Elashry, Mahmoud D Elsharaby and Abd El-naser K Elgamasy Abstract Background: Central nervous system changes, circulatory and electrolyte imbalances are the main complications of endoscopic transurethral resection of the prostate (TURP) which is known as transurethral resection (TUR) syndrome, which occurs as result of excessive absorption of irrigating fluid. We compare glycine 1.5% versus glucose 5% and normal saline 0.9% as irrigating solutions during TURP in patients with moderate to severe bladder outlet obstruction due to benign prostatic hyperplasia (BPH). Methods: Three hundred sixty patients with symptomatic BPH were randomized into a prospective, controlled trial comparing the three irrigation modalities. One-hundred twenty patients used glycine 1.5% solution as irrigating fluid (glycine group), 120 patients used glucose 5% solution (glucose group) and 120 patients used normal saline 0.9% solution (saline group). Patients demographics, operation time, hospital stay, postoperative amino acid glycine assay, postoperative serum cardiac troponin I and perioperative complications were noted. Results: No difference was found between the groups in the immediate postoperative levels of hemoglobin and hematocrite. A high glycine level was associated with the TUR syndrome. Seventeen patients had TUR syndrome; all were in glycine group and they had the highest postoperative amino acid glycine levels. Slight increase in serum sodium (142.6 ± 12.6 mmol/l) was detected in saline group. Transient Hyperglycemia (170 ± 35.9 mg/dl) and hypokal