[A study on hemorrhage during and after operation of TURP (transurethral prostatic resection)--effect of morphine or buprenorphine for suppression of postoperative hemorrhage by epidural infusion].
The majority of hemorrhages occurring during open prostatectomy are induced during the steps for removal of adenoma. However, the hemorrhage during transurethral prostatic resection (TURP) usually takes place at its initial stage, and approx. 50% of the amount of the hemorrhage during the operation occurred within 30 minutes after initiating the operation. When the resection of the adenoma advanced near the surgical capsule, the amount of hemorrhage decreased sharply. This was interpreted to indicate that many of the blood vessels are cut at the initial stage of the operation and that the steps for resection are processed at that stage without special attempt to stop the hemorrhage. We have discussed some aspects for improvement of the methodology for the operation of this kind. The postoperative progress of hemorrhage revealed that the operative cases can be classified into three groups; one was the group with smooth hemostasis since immediately after the operation (Type I and II) and the others were the group with satisfactory hemostasis during the operation and yet with resumption of substantial hematuria (Type III and IV) and the group with continued hemorrhage of substantial amount since immediately after the operation (Type V). It was demonstrated that those showing hematuria of more than 2% at 2-4 hours after the operation and 0.5-1.9% at 6-8 hours after the operation can be rated as falling under the latter two groups and that the check at an early stage and early counter-treatment would induce favorable postoperative progress.(ABSTRACT TRUNCATED AT 250 WORDS)
D002047:Buprenorphine / Q000008:administration & dosage / Q000627:therapeutic use*; D006417:Hematuria / Q000188:drug therapy; D006470:Hemorrhage / Q000188:drug therapy*; D006801:Humans; D007431:Intraoperative Complications / Q000188:drug therapy*; D008297:Male; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy*; D011468:Prostatectomy / Q000379:methods*; D011470:Prostatic Hyperplasia / Q000601:surgery
D002047:Buprenorphine; D009020:Morphine