Transurethral resection syndrome: effect of the introduction into clinical practice of a new method for monitoring fluid absorption.
OBJECTIVE
To determine the effects of introduction of a new monitoring system for fluid absorption during transurethral resection of the prostate (TURP) using an irrigating solution containing 0.5% alcohol.


METHODS
Prospective clinical investigation, with implementation of statistical process control.


METHODS
Inpatients for TURP at a major non-university teaching hospital.


METHODS
312 male ASA physical status I, II, III, and IV patients scheduled for TURP.


METHODS
Intraoperative breath alcohol levels were measured for detection of fluid absorption.


RESULTS
Calculation of the amount of fluid absorbed using measured breath alcohol values. Process variability (i.e., numbers of patients with significant fluid absorption) was defined by statistical process control tools. No trend change of prevalence of fluid absorption was noted until 150 procedures had been completed. Reduction of prevalence of significant fluid absorption was noted and no patients were treated postoperatively in the intensive care unit. No relevant side effects were seen in patients with significant fluid absorption. No mortality and no severe clinical morbidity was seen after the introduction of the new monitoring.


CONCLUSIONS
Using an irrigating fluid marked with 0.5% ethanol resulted in a decreased prevalence of fluid absorption over time.
Department of Anesthesiology, Kantonsspital, Lucerne, Switzerland.
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Konrad
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Gerber
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Schuepfer
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Schmucki
D000042:Absorption; D000368:Aged; D001944:Breath Tests; D000431:Ethanol / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics; D006801:Humans; D007038:Hypotonic Solutions / Q000009:adverse effects* / Q000032:analysis / Q000493:pharmacokinetics; D007202:Indicators and Reagents / Q000008:administration & dosage / Q000032:analysis / Q000493:pharmacokinetics; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D016343:Monitoring, Intraoperative; D011183:Postoperative Complications / Q000517:prevention & control; D015995:Prevalence; D011446:Prospective Studies; D011468:Prostatectomy / Q000009:adverse effects*; D013577:Syndrome; D007507:Therapeutic Irrigation / Q000009:adverse effects
D007038:Hypotonic Solutions; D007202:Indicators and Reagents; D000431:Ethanol