Double-blind randomized study of symptoms associated with absorption of glycine 1.5% or mannitol 3% during transurethral resection of the prostate.
OBJECTIVE
We studied which irrigating fluid, glycine 1.5% or mannitol 3%, is associated with the most favorable adverse effects profile when absorbed by the patient during transurethral resection of the prostate.


METHODS
Irrigating fluid bags containing mannitol 3% or glycine 1.5%, both with added ethanol 1% as an indicator of fluid absorption, were used in a randomized double-blind fashion during 394 transurethral prostatic resections. The incidence of 13 symptoms was studied in 52 patients (13%) who absorbed more than 500 ml. fluid.


RESULTS
The incidence of circulatory symptoms did not differ between the fluids but the risk of neurological symptoms, such as nausea, after transurethral prostatic resection was 4.8 times higher when glycine 1.5% was absorbed (p <0.04). An increase of 1,000 ml. in the volume of irrigant absorbed increased the overall risk for circulatory symptoms by a factor of 3.4 (p <0.03) and the risk of neurological symptoms by a factor of 4.4 (p <0.02).


CONCLUSIONS
Absorption of mannitol 3% during transurethral prostatic resection is associated with fewer neurological symptoms than glycine 1.5%.
Hahn
R G
RG
Department of Anesthesia, South Hospital, Stockholm, Sweden.
Sandfeldt
L
L
Nyman
C R
CR
D000042:Absorption; D000339:Affect / Q000187:drug effects; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D001919:Bradycardia / Q000139:chemically induced; D016001:Confidence Intervals; D003221:Confusion / Q000139:chemically induced; D004311:Double-Blind Method; D000431:Ethanol / Q000008:administration & dosage; D005221:Fatigue / Q000139:chemically induced; D005998:Glycine / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008353:Mannitol / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D016017:Odds Ratio; D011468:Prostatectomy; D012307:Risk Factors; D007507:Therapeutic Irrigation; D013997:Time Factors
D000431:Ethanol; D008353:Mannitol; D005998:Glycine