Effect of spinal versus general anesthesia on bladder compliance and intraabdominal pressure during transurethral procedures.
OBJECTIVE
To evaluate the influence of spinal versus general anesthesia on bladder compliance and intraabdominal pressure in elderly males undergoing elective transurethral resection of the prostate.


METHODS
Prospective, randomized, open-label study.


METHODS
Teaching hospital.


METHODS
21 ASA physical status I, II, and III patients at least 18 years of age, undergoing transurethral surgery.


METHODS
According to a computer-generated randomization schedule, patients were allocated to one of two groups. In Group Spinal (S), 10 mg of hyperbaric tetracaine was administered intrathecally. In Group General Anesthesia (GA), patients received, fentanyl intravenous (i.v. 1 to 2 micrograms/kg and propofol i.v. 1.0 to 2.0 mg/kg for induction of anesthesia. Thereafter, a laryngeal mask airway was inserted and, with spontaneous ventilation, anesthesia was maintained by administering isoflurane (end-tidal 0.7% to 1.2%) and 70% nitrous oxide (N2O) in oxygen. Intraabdominal pressure and bladder compliance were recorded prior to the induction of anesthesia and immediately before the onset of the surgical procedure.


RESULTS
The two groups were demographically comparable. In Group S, mean bladder compliance was significantly (p = 0.003) higher and mean intraabdominal pressure significantly lower (p = 0.007) when compared to baseline preanesthetic values. In Group GA, mean intraabdominal pressure significantly (p = 0.006) decreased when compared to baseline preanesthetic recordings. Following the induction of general anesthesia, a small change in bladder compliance was noted. However, statistical significance was not reached. Data were analyzed and compared using Student's t-test (p < 0.05 was considered statistically significant).


CONCLUSIONS
Both spinal and general anesthesia induced a significant decrease in intraabdominal pressure. While both techniques were associated with an increase in bladder compliance, statistical significance was demonstrated only in the spinal anesthesia treatment group.
Olsfanger
D
D
Department of Anesthesiology and Intensive Care, Meir Hospital, Kfar Saba, Israel.
Zohar
E
E
Fredman
B
B
Richter
S
S
Jedeikin
R
R
D000005:Abdomen / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D000775:Anesthesia, Spinal; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D017558:Elective Surgical Procedures; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage; D017214:Laryngeal Masks; D008297:Male; D008875:Middle Aged; D009609:Nitrous Oxide / Q000008:administration & dosage; D011312:Pressure; D015742:Propofol / Q000008:administration & dosage; D011446:Prospective Studies; D011468:Prostatectomy / Q000379:methods*; D013748:Tetracaine / Q000008:administration & dosage; D001743:Urinary Bladder / Q000187:drug effects / Q000502:physiology*; D014563:Urodynamics / Q000187:drug effects / Q000502:physiology*
D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D013748:Tetracaine; D007530:Isoflurane; D009609:Nitrous Oxide; D005283:Fentanyl; D015742:Propofol