Feasibility of radical perineal prostatectomy under spinal anaesthesia.
OBJECTIVE
To evaluate the possibility of a perineal radical prostatectomy (PRP) under spinal anaesthesia, as although it is usually done under general anaesthesia, there is currently a need to minimize costs and morbidity.


METHODS
Between January and December 2003, there were 337 PRPs at our institution, of which 47 were on patients under combined spinal/epidural (CSE) anaesthesia administered via a standard L3/4 or L4/5 approach. We analysed the feasibility of PRP under CSE and evaluated perioperative morbidity, including blood loss and hospital stay.


RESULTS
All 47 procedures were done under CSE with no need for conversion to general anaesthesia. The mean (range) duration of PRP was 56 (43-112) min, the mean blood loss 270 mL, and the transurethral catheter was removed at 7 days in 40 and at 14 days in the remaining seven patients. There were no complications during surgery, e.g. rectal or ureteric lesions. The mean hospital stay was 8.2 days.


CONCLUSIONS
PRP is safe under CSE anaesthesia; this may be helpful in minimizing morbidity and medical costs, as well as providing an alternative in patients in whom general anaesthesia is not recommended.
Department of Urology, Evang & Johanniter Hospital Oberhausen, Germany. Jan.Fichtner@ejk.de
Jan
J
Fichtner
Dagnew
D
Mengesha
Gert
G
Hutschenreiter
Ralf
R
Scherer
D000368:Aged; D000767:Anesthesia, Epidural / Q000379:methods; D000775:Anesthesia, Spinal / Q000379:methods*; D016063:Blood Loss, Surgical; D005240:Feasibility Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000601:surgery*