Monitoring irrigating fluid absorption during transurethral resection of the prostate (TURP); a comparison between 1 and 2% ethanol as a tracer.
In a series of 35 transurethral resections of the prostate 1% ethanol was compared to 2% ethanol as a marker of the irrigating fluid. The ethanol concentration in the expired breath of the patient (EB-ethanol) correlated significantly to the irrigant absorption, as measured volumetrically, and to the change in the serum sodium concentration at 10-min intervals during the operation. The pattern of changes in EB-ethanol indicated whether the main part of the absorption entered through the intravenous or the extravascular route. With 1% ethanol added to the irrigating solution the absorption of 100-150 ml in 10 min could readily be detected. The sensitivity was twice as great with 2% ethanol; however, 1% ethanol is sufficient for routine procedures as it permits absorption to be detected long before it is large enough to produce a TUR syndrome. Monitoring ethanol in the expired breath provides the surgeon with an instrument to check that preventive steps against further absorption are effective.
Department of Surgery, Piteå County Hospital, Sweden.
J O
JO
Hultén
R G
RG
Hahn
D000368:Aged; D001944:Breath Tests; D000431:Ethanol; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D011468:Prostatectomy; D012964:Sodium / Q000097:blood; D007507:Therapeutic Irrigation; D014882:Water-Electrolyte Balance; D014883:Water-Electrolyte Imbalance / Q000175:diagnosis / Q000209:etiology
D000431:Ethanol; D012964:Sodium