Anesthesia for Urologic Surgery

Complications of robotic and laparoscopic urologic surgery relevant to anesthesia
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Kimball I. Cystoscopy and ureteroscopy are performed to diagnose and treat lesions of the lower urethra, prostate, and bladder and upper ureter and kidney urinary tracts.

  • Duration of Stay After Urologic Surgery : Neuraxial Versus General Anesthesia.
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Warmed irrigation fluids are used to improve visualization and to remove blood, tissue, and stone fragments. Because of ionization, they cannot safely be used for procedures involving monopolar electrocautery. However, these solutions can be used with newer, bipolar electrocautery. Sterile water has optimal visibility and is nonconductive. Nonelectrolyte solutions of glycine, sorbitol, and mannitol have good visibility and are nonconductive.

Near isotonicity minimizes hemolysis, although large volume absorption may cause hyponatremia see section 3. Anesthesia a. Placement of a rigid cystoscope particularly in males and distention of the bladder and ureters can be quite stimulating.

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Two of these patients returned to theatre because bleeding problems; one, with abnormal renal vasculature, may have had a splenic infarct. Reprints and Permissions. Postoperative ventilation may be needed because of prolonged retraction of the lung that is causing contusion. Systematic review is a research method that pools the results from individual trials and can resolve conflicts in the literature. One of the most serious complications of spinal anesthesia is cardiac arrest [ 17 — 19 ]. Varying dose of Hyperbaric Bupivacaine. The median nerve is susceptible to neuropathy due to excessive stretching as it courses through the antecubital fossa.

Postoperative pain is minimal. If regional anesthesia is used, a T6 level is required for upper tract instrumentation, whereas a T10 level is adequate for lower tract surgery. GA can be effective with short-acting intravenous IV and inhaled anesthetics.

Can Spinal Replace General Anesthesia in Pediatric Urology Patients?

Transient muscle relaxation may be required. Lithotomy position is most common. Transurethral resection of the bladder TURB is performed to diagnose and treat lesions of the bladder anesthetic considerations are similar to TURP—see below. Muscle relaxation should be considered as inadvertent simulation of the obturator nerve, deep to the lateral bladder wall, may result in leg adduction, thus risking damage to the bladder.

This procedure uses a modified cystoscope resectoscope with a wire loop connected to an electrocautery unit for resection of tissue and coagulation of bleeding vessels. During surgery, large prostatic venous sinuses can be opened, which allow irrigant to be absorbed. The quantity of fluid absorbed depends on the following factors: a. Irrigant hydrostatic pressure, proportional to the height of the irrigant above the patient. Surgical technique: duration of exposed sinuses, irrigation flow rate, and cystoscope size. Varying dose of Hyperbaric Bupivacaine. The comparison of levobupivacaine in continuous or single dose spinal anesthesia for transurethral resection of prostate surgery. Rev Bras Anestesiol. Continuous spinal anesthesia with a microcatheter and Low-dose bupivacaine decreases the hemodynamic effects of centroneuraxis block in elderly patients.

Anesth Analg. Incremental dosing versus single-dose spinal anesthesia and hemodynamic stability.

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Hemodynamic effects of spinal anesthesia in the elderly: single dose versus titration through a catheter. The median effective dose of intrathecal hyperbaric bupivacaine is larger in the single-shot spinal as compared with the combined spinal-epidural technique. Spinal anesthesia using single injection small-dose bupivacaine versus continuous catheter injection techniques for surgical repair of Hip fracture in elderly patients. Aneth Analg. Continuous spinal anesthesia versus single small dose bupivacaine-fentanyl spinal anesthesia in high risk elderly patients: a randomized controlled trial.

Egyptian Journal of Anaesthesia. Davis H. Density, specific gravity, and baricity of spinal anesthetic solution at body temperature. Gaiser RR. Spinal, epidural, and caudal anesthesia. Philadelpha: W.


Can J Anaesth. Modifying the baricity of local anesthetics for spinal anesthesiology by temperature adjustment.

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Pollard JB. Cardiac arrest during spinal anesthesia: common mechanisms and strategies for prevention. Cardiac arrest after spinal anesthesia in a patient with neutrally mediated syncope. J Anesth. Unanticipated cardiac arrest under spinal anesthesia: an unavoidable mystery with review of current literature. Anesth Essays Res. Comparison of intrathecal fentanyl and sufentanyl in lowdose dilute bupivacaine spinal anaesthesia for transurethral prostatectomy.

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Br J Anaesth. Efficacy of spinal ropivacaine versus ropivacaine with fentanyl in transurethral resection operations. Saudi J Anesth. Low-dose bupivacaine-fentanyl spinal anesthesia for cesarean delivery.

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Because of the variable techniques and patients' positions used in urological surgery, anesthesia for urologic surgery requires advanced. height of bag,; duration of surgery,; degree of distension, and; size of openings into venous sinusoids. ~ absorbed. ANAESTHESIA FOR TURP.

Reg Anesth Pain Med. Low-dose bupivacaine with sufentanil prevents hypotention after spinal anesthesia for hip repair in elderly patients. Acta Anaesthesiol Sand. Combination of ultra-low dose bupivacaine and fentanyl for spinal anaesthesia in Out-patient anorectal surgery. Warning You have reached the maximum number of saved studies Duration of Stay After Urologic Surgery : Neuraxial Versus General Anesthesia The safety and scientific validity of this study is the responsibility of the study sponsor and investigators.

Listing a study does not mean it has been evaluated by the U. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Last Update Posted : June 4, See Contacts and Locations. Study Description. Outcome Measures. Primary Outcome Measures : The investigators compared the rate of complications after TVT surgery depending on the type of anesthesia and the need for urinary catheterization, requiring longer hospital stay after surgery. Eligibility Criteria.

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