title: Epidural and general anesthesia versus general anesthesia in radical prostatectomy.
abstract: Induced hypotension with epidural anesthesia influences the intraoperative blood loss in prostate cancer patients undergoing radical prostatectomy. The aim of this study was to evaluate intraoperative blood loss and need of blood transfusions in patients who underwent radical prostatectomy under epidural/general anesthesia and general anesthesia. Two groups were selected: epidural/general anesthesia group (study group, 27 patients) received epidural anesthesia in association with general anesthesia, and general anesthesia group (control group, 27 patients) received general anesthesia alone. Epidural/general anesthesia was performed using 0.5% solution of bupivacaine and maintained by volatile anesthetic sevoflurane. General anesthesia was performed with endotracheal ventilation using sevoflurane and intravenous fentanyl. The present study showed that the mean blood loss in epidural/general anesthesia group was significantly lower in comparison with that of general anesthesia group (740+/-210 mL versus 1150+/-290 mL, P<0.001). In addition, less allogeneic blood was transfused in epidural/general anesthesia group: 0.19 blood units transfused versus 0.52 blood units in general anesthesia group (P=0.007). Our study proved that induced hypotension with epidural/general anesthesia reduced intraoperative blood loss and need of allogeneic blood transfusions in cancer patient undergoing open radical prostatectomy.
authors.affiliation: Institute of Oncology, Vilnius University, Santariskiu 1, 08660 Vilnius, Lithuania. renatas.tikuisis@gmail.com
authors.forename: Renatas
authors.initials: R
authors.lastname: Tikuisis
authors.forename: Povilas
authors.initials: P
authors.lastname: Miliauskas
authors.forename: Narimantas Evaldas
authors.initials: NE
authors.lastname: Samalavicius
authors.forename: Aleksas
authors.initials: A
authors.lastname: Zurauskas
authors.forename: Algimantas
authors.initials: A
authors.lastname: Sruogis
mesh_terms: D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D016063:Blood Loss, Surgical; D001794:Blood Pressure; D001803:Blood Transfusion; D015992:Body Mass Index; D002045:Bupivacaine / Q000008:administration & dosage; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007258:Informed Consent; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage; D008875:Middle Aged; D008954:Models, Biological; D009367:Neoplasm Staging; D019106:Postoperative Hemorrhage / Q000209:etiology; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery; D000077149:Sevoflurane; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D008738:Methyl Ethers; D000077149:Sevoflurane; D005283:Fentanyl; D002045:Bupivacaine