title: Does an alcolmeter in the hands of an anesthesiologist make TURP safer? - Results from a case-control study.
abstract: BACKGROUND
  This hospital-based, prospective, case-controlled study was carried out to monitor fluid absorption during transurethral resection of the prostrate (TURP) by marking the irrigating fluid with ethanol for signs of TURP syndrome. Addition of ethanol allows early detection and prevention of full blown TURP syndrome as also the volume of fluid absorbed can be measured.
  
  
  METHODS
  Patients were divided into two groups of 50 each, taking males undergoing TURP belonging to ASA (American Society of Anesthesiologists) I and II. Group 1 received irrigation with 1.5% glycine alone and group 2 received irrigation with 1.5% glycine along with ethanol during TURP. The primary outcome measure was the detection of TURP syndrome using end expiratory ethanol levels and comparing with serum electrolytes and clinical manifestations. The secondary outcome measures, the hemodynamic parameters such as heart rate, systolic and diastolic pressures, and oxygen saturation were recorded during the intraoperative period after spinal anesthesia and then postoperatively till the end of the first hour in the recovery room.
  
  
  METHODS
  Chi-square test, Student's t-test and Pearson's correlation coefficient 'r'.
  
  
  RESULTS
  Mean resection time in the ethanol positive patients (36.36 min) was significantly higher than that in the ethanol negative patients (22.08 min) (P < 0.01). The estimated fluid absorbed was statistically significant in 45 minutes of resection in three patients with positive ethanol readings (P < 0.05). Resection was temporally stopped in 16 patients (32%) and permanently in 1 patient (2%), whose resection time reached 60 min. A positive correlation was found between total fall in serum sodium and maximum expiratory ethanol concentration. There was a significant difference in the heart rate between the two groups in the 40(th) minute (P < 0.05).
  
  
  CONCLUSIONS
  Ethanol is a noninvasive, easy-to-use marker in irrigating fluid for assessing fluid absorption. It forewarns to take corrective measures earlier than both fall in sodium and manifestations of TURP syndrome, allowing successful completion of TURP.
authors.affiliation: Department of Anaesthesiology, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Christina
authors.initials: C
authors.lastname: George
authors.affiliation: Department of Anaesthesiology, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Baljinder
authors.initials: B
authors.lastname: Kaur
authors.affiliation: Department of Surgery, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Parvez D
authors.initials: PD
authors.lastname: Haque
authors.affiliation: Department of Urology, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Kim
authors.initials: K
authors.lastname: Mammen
keywords: Ethanol alcolmeter fluid absorption glycine TURP