Skip to main content
Erschienen in: International Urology and Nephrology 2/2012

01.04.2012 | Urology - Original paper

Effect of intraprostatic epinephrine on intraoperative blood loss reduction during transurethral resection of the prostate

verfasst von: Alejandro Lira-Dale, Miguel Maldonado-Ávila, José Fernando Gil-García, Enrique Hans Mues-Guizar, Rubén Nerubay-Toiber, Jose Guzmán-Esquivel, Ivan Delgado-Enciso

Erschienen in: International Urology and Nephrology | Ausgabe 2/2012

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Horninger W, Unterlechner H, Strasser H et al (1996) Transurethral prostatectomy: mortality and morbidity. Prostate 28(3):195–200PubMedCrossRef Horninger W, Unterlechner H, Strasser H et al (1996) Transurethral prostatectomy: mortality and morbidity. Prostate 28(3):195–200PubMedCrossRef
2.
Zurück zum Zitat Reich O, Gratzke C, Bachmann A et al (2008) Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10654 patients. J Urol 180(1):246–249PubMedCrossRef Reich O, Gratzke C, Bachmann A et al (2008) Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10654 patients. J Urol 180(1):246–249PubMedCrossRef
3.
Zurück zum Zitat Rassweiler J, Teber D, Kuntz R et al (2006) Complications of transurethral resection of the prostate (TURP)–incidence, management, and prevention. Eur Urol 50(5):969–979PubMedCrossRef Rassweiler J, Teber D, Kuntz R et al (2006) Complications of transurethral resection of the prostate (TURP)–incidence, management, and prevention. Eur Urol 50(5):969–979PubMedCrossRef
4.
Zurück zum Zitat Shrestha BM, Prasopshanti K, Matanhelia SS et al (2008) Blood loss during and after transurethral resection of prostate: a prospective study. Kathmandu Univ Med J 6(23):329–334 Shrestha BM, Prasopshanti K, Matanhelia SS et al (2008) Blood loss during and after transurethral resection of prostate: a prospective study. Kathmandu Univ Med J 6(23):329–334
5.
Zurück zum Zitat Burnett AL, Wein AJ (2006). Benign prostatic hyperplasia in primary care: what you need to know. J Urol 175 (3 Pt 2):S19–24 Burnett AL, Wein AJ (2006). Benign prostatic hyperplasia in primary care: what you need to know. J Urol 175 (3 Pt 2):S19–24
6.
Zurück zum Zitat Sinnott CJ, Lawrence P, Cogswell III (2003) On the mechanism by which epinephrine potentiates lidocaine′s peripheral nerve block. Anesthesiology 98(1):181–188PubMedCrossRef Sinnott CJ, Lawrence P, Cogswell III (2003) On the mechanism by which epinephrine potentiates lidocaine′s peripheral nerve block. Anesthesiology 98(1):181–188PubMedCrossRef
7.
Zurück zum Zitat Gasparini G, Papaleo P, Pola P, Cerciello S, Pola E, Fabbriciani C (2006) Local infusion of norepinephrine reduces blood losses and need of transfusion in total knee arthroplasty. Int Orthop 30(4):253–256PubMedCrossRef Gasparini G, Papaleo P, Pola P, Cerciello S, Pola E, Fabbriciani C (2006) Local infusion of norepinephrine reduces blood losses and need of transfusion in total knee arthroplasty. Int Orthop 30(4):253–256PubMedCrossRef
8.
Zurück zum Zitat Chung SCS, Leung JWC, Steele RJC et al (1988) Endoscopic injection of adrenaline for actively bleeding ulcers: a randomized trial. Br Med J (Clin Res Ed) 296:1631–1633CrossRef Chung SCS, Leung JWC, Steele RJC et al (1988) Endoscopic injection of adrenaline for actively bleeding ulcers: a randomized trial. Br Med J (Clin Res Ed) 296:1631–1633CrossRef
9.
Zurück zum Zitat Schelin S (2009) Transurethral resection of the prostate after intraprostatic injection of mepivacaine epinephrine: a preliminary communication. Scand J Urol Nephrol 43(1):63–67PubMedCrossRef Schelin S (2009) Transurethral resection of the prostate after intraprostatic injection of mepivacaine epinephrine: a preliminary communication. Scand J Urol Nephrol 43(1):63–67PubMedCrossRef
10.
Zurück zum Zitat Schelin S, Claezon A, Sundin A et al (2004) Effects of intraprostatic and periprostatic injections of mepivacaine epinephrine on intraprostatic blood flow during transurethral microwave thermotherapy: correlation with (15O) H2O-PET. J Endourol 18(10):965–970PubMedCrossRef Schelin S, Claezon A, Sundin A et al (2004) Effects of intraprostatic and periprostatic injections of mepivacaine epinephrine on intraprostatic blood flow during transurethral microwave thermotherapy: correlation with (15O) H2O-PET. J Endourol 18(10):965–970PubMedCrossRef
11.
Zurück zum Zitat Heathcote PS, Dyer PM (1986) The effect of warm irrigation on blood loss during transurethral prostatectomy under spinal anesthesia. Br J Urol 58(6):669–671PubMedCrossRef Heathcote PS, Dyer PM (1986) The effect of warm irrigation on blood loss during transurethral prostatectomy under spinal anesthesia. Br J Urol 58(6):669–671PubMedCrossRef
12.
Zurück zum Zitat Mori K, Shigehiro O, Masao A (1995) Ethanol injection prior to transurethral resection of the prostate for prevention of perioperative blood loss. Urology 45(1):171PubMedCrossRef Mori K, Shigehiro O, Masao A (1995) Ethanol injection prior to transurethral resection of the prostate for prevention of perioperative blood loss. Urology 45(1):171PubMedCrossRef
13.
Zurück zum Zitat Walker EM, Bera S, Faiz M (1995) Does catheter traction reduce post-transurethral resection of the prostate blood loss? Br J Urol 75:614–617PubMedCrossRef Walker EM, Bera S, Faiz M (1995) Does catheter traction reduce post-transurethral resection of the prostate blood loss? Br J Urol 75:614–617PubMedCrossRef
14.
Zurück zum Zitat Luke M, Kvist E, Andersen F et al (1986) Reduction of post-operative bleeding after transurethral resection of the prostate by local instillation of fibrin adhesive (Beriplast). Br J Urol 58(6):672–675PubMedCrossRef Luke M, Kvist E, Andersen F et al (1986) Reduction of post-operative bleeding after transurethral resection of the prostate by local instillation of fibrin adhesive (Beriplast). Br J Urol 58(6):672–675PubMedCrossRef
15.
Zurück zum Zitat Ukimura O, Kawauchi A, Kanazawa M et al (2005) Preoperative administration of chlormadinone acetate reduces blood loss associated with transurethral resection of the prostate: a prospective randomized study. BJU Int 96(1):98–102PubMedCrossRef Ukimura O, Kawauchi A, Kanazawa M et al (2005) Preoperative administration of chlormadinone acetate reduces blood loss associated with transurethral resection of the prostate: a prospective randomized study. BJU Int 96(1):98–102PubMedCrossRef
16.
Zurück zum Zitat Hahn RG, Fagerstrom T, Tammela TL et al (2007) Blood loss and postoperative complications associated with transurethral resection of the prostate after pretreatment with dutasteride. BJU Int 99(3):587–594PubMedCrossRef Hahn RG, Fagerstrom T, Tammela TL et al (2007) Blood loss and postoperative complications associated with transurethral resection of the prostate after pretreatment with dutasteride. BJU Int 99(3):587–594PubMedCrossRef
17.
Zurück zum Zitat Tuncel A, Ener K, Han O et al (2009) Effects of short-term dutasteride and serenoa repens on perioperative bleeding and microvessel density in patients undergoing transurethral resection of the prostate. Scand J Urol Nephrol 43(5):377–382PubMedCrossRef Tuncel A, Ener K, Han O et al (2009) Effects of short-term dutasteride and serenoa repens on perioperative bleeding and microvessel density in patients undergoing transurethral resection of the prostate. Scand J Urol Nephrol 43(5):377–382PubMedCrossRef
18.
Zurück zum Zitat Sandfeldt L, Bailey DM, Hahn R (2001) Blood loss during transurethral resection of the prostate after 3 months of treatment with finasteride. Urology 58(1):972–976PubMedCrossRef Sandfeldt L, Bailey DM, Hahn R (2001) Blood loss during transurethral resection of the prostate after 3 months of treatment with finasteride. Urology 58(1):972–976PubMedCrossRef
19.
Zurück zum Zitat Shoroghi M, Sadrolsadat SH, Razzaghi M, Farahbakhsh F, Sheikhvatan M, Sheikhfathollahi M, Abbasi A (2008) Effect of different epinephrine concentrations on local bleeding and hemodynamics during dermatologic surgery. Acta Dermatovenerol Croat 16(4):209–214PubMed Shoroghi M, Sadrolsadat SH, Razzaghi M, Farahbakhsh F, Sheikhvatan M, Sheikhfathollahi M, Abbasi A (2008) Effect of different epinephrine concentrations on local bleeding and hemodynamics during dermatologic surgery. Acta Dermatovenerol Croat 16(4):209–214PubMed
20.
Zurück zum Zitat Tas E, Hanci V, Ugur MB, Turan IO, Yigit VB, Cinar F (2010) Does preincisional injection of levobupivacaine with epinephrine have any benefits for children undergoing tonsillectomy? An intraindividual evaluation. Int J Pediatr Otorhinolaryngol 74(10):1171–1175PubMedCrossRef Tas E, Hanci V, Ugur MB, Turan IO, Yigit VB, Cinar F (2010) Does preincisional injection of levobupivacaine with epinephrine have any benefits for children undergoing tonsillectomy? An intraindividual evaluation. Int J Pediatr Otorhinolaryngol 74(10):1171–1175PubMedCrossRef
21.
Zurück zum Zitat Menon S (2008) Epinephrine preinjection of stalked colonic polyps. Gastrointest Endosc 67(7):1214PubMedCrossRef Menon S (2008) Epinephrine preinjection of stalked colonic polyps. Gastrointest Endosc 67(7):1214PubMedCrossRef
Metadaten
Titel
Effect of intraprostatic epinephrine on intraoperative blood loss reduction during transurethral resection of the prostate
verfasst von
Alejandro Lira-Dale
Miguel Maldonado-Ávila
José Fernando Gil-García
Enrique Hans Mues-Guizar
Rubén Nerubay-Toiber
Jose Guzmán-Esquivel
Ivan Delgado-Enciso
Publikationsdatum
01.04.2012
Verlag
Springer Netherlands
Erschienen in
International Urology and Nephrology / Ausgabe 2/2012
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-011-0071-2

Weitere Artikel der Ausgabe 2/2012

International Urology and Nephrology 2/2012 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Aquatherapie bei Fibromyalgie wirksamer als Trockenübungen

03.05.2024 Fibromyalgiesyndrom Nachrichten

Bewegungs-, Dehnungs- und Entspannungsübungen im Wasser lindern die Beschwerden von Patientinnen mit Fibromyalgie besser als das Üben auf trockenem Land. Das geht aus einer spanisch-brasilianischen Vergleichsstudie hervor.

Wo hapert es noch bei der Umsetzung der POMGAT-Leitlinie?

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Das Risiko für Vorhofflimmern in der Bevölkerung steigt

02.05.2024 Vorhofflimmern Nachrichten

Das Risiko, im Lauf des Lebens an Vorhofflimmern zu erkranken, ist in den vergangenen 20 Jahren gestiegen: Laut dänischen Zahlen wird es drei von zehn Personen treffen. Das hat Folgen weit über die Schlaganfallgefährdung hinaus.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.