Detection of fluid volume absorption by end-tidal alcohol monitoring in patients undergoing endoscopic renal pelvic surgery.
OBJECTIVE
To determine the risk of relevant fluid absorption (calculated volume above 500 ml) during endoscopic procedures of the renal pelvis.


METHODS
Prospective clinical investigation with implementation of statistical process control tools (SPC).


METHODS
Nonuniversity teaching hospital.


METHODS
62 consecutive ASA physical status I and II patients scheduled for endoscopic renal pelvic surgery with general anesthesia.


METHODS
Intraoperative measurement of breath alcohol for detection of fluid absorption. Irrigation fluid (0.9% saline) with 1% alcohol for tracing the irrigation fluid.


RESULTS
Calculation of the amount of fluid absorbed using breath alcohol values. Process variability (numbers of patients with relevant fluid absorption) defined by SPC. The prevalence of fluid absorption in endoscopic renal pelvic surgery was 6%. Peak fluid absorption during a vascular route was detected by the monitoring. Monitoring was easily introduced into routine clinical practice. No relevant side effects due to the monitoring were seen in patients with relevant fluid absorption. There was no mortality, but two patients with detected severe fluid overload were admitted to the intensive care unit for treatment.


CONCLUSIONS
Breath alcohol levels during general anesthesia for endoscopic renal pelvic surgery were technically simple to measure. Our results show the predictive value of alcohol monitoring, which has been previously demonstrated only for transurethral prostatectomy. The prevalence of relevant fluid absorption was 6% compared to 13% during transurethral resection of the prostate.
Konrad
C
C
Department of Anesthesiology and Intensive Care, Kantonsspital, Lucerne, Switzerland. Fieber-Konrad@t-online.de
Gerber
H
H
Schupfer
G
G
Jenzer
S
S
Schmucki
O
O
D000042:Absorption; D001944:Breath Tests; D004724:Endoscopy; D000431:Ethanol; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D007507:Therapeutic Irrigation / Q000009:adverse effects; D020728:Transurethral Resection of Prostate
D000431:Ethanol