Central pontine myelinolysis from rapid overcorrection. A regional technique allows the anesthesiologist to monitor the neurologic status of the patient throughout the procedure. Conflict: preference for neuraxial technique to monitor CNS symptoms vs. any contraindications to neuraxial. The extent to which this occurs depends on the height of the irrigating solution container above the surgical table (resulting in hydrostatic pressure driving the fluid into the sinuses) and the resection time. Transurethral Resection Syndrome. Hyponatremia . Urinary retention is common after anesthesia and surgery, reported incidence of between 5% and 70%. A very different fluid and solute dynamic occurs during “TURBT syndrome” compared with the “TURP syndrome.” Peritoneum is a biologic membrane and the net effects of fluids and solute shifts between the capillary blood and the intraperitoneal fluid depends on both the amount and composition of intraperitoneally extravasated fluid. Comorbidities, type of surgery, and type of anesthesia influence the development of postoperative urinary retention (POUR). Radziwill AJ, Vuadens P, Borruat FX, Bogousslavsky J. J Int Med Res 2003; 31:152. Irrigating solution will be absorbed through the large prostatic venous sinuses. Prevention or early recognition of TURP syndrome. syndrome • Decompensated CHF • Significant arrhythmias • Severe valvular disease * Down's Syndrome (see attachments) ANESTH ANALG 2002: 94: 1052-64 12. This condition, known as TURP syndrome or transurethral resection (TUR) syndrome, can be life-threatening if untreated. Some men require follow-up treatment after TURP … STEP 8 STEP 6 Intermediate Clinical Predictors† • Mild angina pectoris • Prior Ml • Compensated or prior CHF • Diabetes mellitus Karci A, Erkin Y. Acute vs. chronic hyponatremia . Need for re-treatment. Visual disturbances and transurethral resection of the prostate: the TURP syndrome. Clinical indications for epidural anesthesia and analgesia have expanded significantly over the past several decades. Transient blindness following hysteroscopy. However, the techniques used in TURP are not entirely comparable to hysteroscopic surgery as the uterus has a very thick wall, which requires higher distension pressures. TURP syndrome. Considerations . The risk of TURP syndrome has led anesthesiologists to prefer SAB for TURP. Absorption of large volumes of irrigating solution leads to respiratory distress secondary to intravascular volume overload, hyponatremia, and hypo-osmolality ().The average amount of irrigating fluid absorbed during TURP is … Attention to blood loss & appropriate replacement. Problems in PAR include: post-op delirium, hypotension, respiratory distress (need to consider comorbidities) TURP Syndrome Before offering a patient spinal anesthesia, an anesthesiologist not only must be aware of the indications and contraindications of spinal anesthesia but also must be able to weigh the risks and benefits of performing the procedure. The prevalence of Brugada syndrome ranges from 1 in 5,000 to 1 in 2,000, and the incidence of Brugada syndrome pattern on electrocardiogram from 0.12 to 0.8%, 3 while malignant arrhythmias may be triggered by a number of conditions (the most common is fever) and drugs. Wang JM, Creel DJ, Wong KC. Information gathered from patients with post-transurethral resection of the prostate (TURP) syndrome has been useful in the treatment of gynaecology patients. Physiologic manifestations (severe = neurologic symptoms or < 120 mEq/L): A technique called bipolar TURP eliminates the risk of this condition. 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