title: Effect of intraprostatic epinephrine on intraoperative blood loss reduction during transurethral resection of the prostate.
abstract: OBJECTIVE
  To determine whether the use of intraprostatic epinephrine during transurethral resection of the prostate reduces intraoperative blood loss.
  
  
  METHODS
  A random, double-blind, prospective study was carried out on twenty-three patients that underwent transurethral resection of the prostate. Patients were divided into two groups: (1) group receiving intraoperative intraprostatic injection of epinephrine (thirteen patients) and (2) group receiving intraoperative intraprostatic injection of saline solution as placebo (ten patients). Blood loss was quantified with the following formula: irrigation solution hemoglobin × 1000/intraoperative presurgical serum hemoglobin. The variables analyzed were blood loss, resection time, presurgical prostate volume, and grams of resected tissue. Student´s t test and Pearson correlation were used for their analysis.
  
  
  RESULTS
  There were thirteen patients in the epinephrine group and ten patients in the placebo group. Mean blood loss in the epinephrine group was significantly lower than in the placebo group (127.48 mL ± 77.0 mL vs. 336.63 ± 185.6 mL, 95% CI, 45-234, P < 0.001). There were no statistically significant differences in mean resected grams or mean resection time between the two groups. One patient in the epinephrine group presented with intraoperative hypertensive crisis (7.7%).
  
  
  CONCLUSIONS
  Intraprostatic epinephrine injection can be used to reduce blood loss during transurethral resection of the prostate in selected patients. Cardiovascular monitoring should be carried out during its application. Resection time and grams of resected tissue continue to be the most influential factors in relation to blood loss in patients undergoing this treatment modality.
authors: Department of Urology, Hospital General de México, O.D. Dr. Balmis 148 Col. Doctores Del. Cuauhtémoc, México, DF, México. alex_lira99@yahoo.com
authors: Alejandro
authors: A
authors: Lira-Dale
authors: Miguel
authors: M
authors: Maldonado-Ávila
authors: José Fernando
authors: JF
authors: Gil-García
authors: Enrique Hans
authors: EH
authors: Mues-Guizar
authors: Rubén
authors: R
authors: Nerubay-Toiber
authors: Jose
authors: J
authors: Guzmán-Esquivel
authors: Ivan
authors: I
authors: Delgado-Enciso
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004311:Double-Blind Method; D004837:Epinephrine / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate; D011470:Prostatic Hyperplasia / Q000601:surgery*; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000379:methods*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D014662:Vasoconstrictor Agents; D004837:Epinephrine