title: Epidural anesthesia can block the negative effects of prostaglandin mediators during prostate surgery.
abstract: BACKGROUND
  Inflammation plays a key role in the development of benign prostatic hyperplasia. Prostaglandin E2 (PGE2) is an important inflammation factor found in enlarged prostatic tissue that can be the main cause of inflammatory pain. The aim of this study was to investigate whether epidural anesthesia can block the negative effects of prostaglandin mediators during prostate surgery.
  
  
  METHODS
  The study included 60 patients who underwent open prostatectomy. All patients were randomly allocated to one of two study groups. The first group received general anesthesia and the second group a combination of general and epidural anesthesia. Main outcome measures were plasma concentration of PGE2, adrenaline, noradrenaline, and dopamine, before induction of anesthesia and at the time of enucleation.
  
  
  RESULTS
  Preoperative serum concentrations of PGE2 were high in both groups. During enucleation, serum concentrations of adrenaline, noradrenaline, and dopamine increased, followed by a rise of systolic and diastolic blood pressure in the group of patients that received only general anesthesia. Serum concentration of PGE2 was at the same level as before induction of anesthesia in both groups.
  
  
  CONCLUSIONS
  Epidural anesthesia blocks transmission of painful stimulus through the spinal cord caused by prostaglandin release and prevents the rise of catecholamines and blood pressure. Open prostatectomy can become a safer procedure performed under a combination of general and epidural anesthesia. Negative intraoperative effects of inflammatory prostate mediators during other techniques for prostate surgery could also be blocked with epidural anesthesia.
authors: Department of Anesthesiology, Urology Hospital, Clinical Centre of Serbia, Belgrade, Serbia.
authors: Nebojsa
authors: N
authors: Ladjevic
authors: Otas
authors: O
authors: Durutovic
authors: Ivana
authors: I
authors: Likic-Ladjevic
authors: Natasa
authors: N
authors: Lalic
authors: Ana
authors: A
authors: Mimic
authors: Natasa
authors: N
authors: Dencic
authors: Svetlana
authors: S
authors: Sreckovic
authors: Zoran
authors: Z
authors: Dzamic
authors: Milan
authors: M
authors: Terzic
authors: Aleksandar
authors: A
authors: Vuksanovic
authors: Dragica
authors: D
authors: Milenkovic-Petronic
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D001794:Blood Pressure; D015232:Dinoprostone / Q000097:blood; D004298:Dopamine / Q000097:blood; D004837:Epinephrine / Q000097:blood; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D059035:Perioperative Period; D011468:Prostatectomy; D011470:Prostatic Hyperplasia / Q000097:blood* / Q000150:complications / Q000601:surgery; D011472:Prostatitis / Q000097:blood* / Q000150:complications / Q000601:surgery
chemical_list: D015232:Dinoprostone; D004298:Dopamine; D009638:Norepinephrine; D004837:Epinephrine