The Effect Of Choice Of Irrigation Fluid Containing Phenylephrine On Reducing Blood Loss And Stabilizing Parameters Of Haemodynamics During Transurethral Resection Of The Prostate

Objective: The aims of the study are to investigate the effect of choice of irrigation fluid containing phenylephrine (6mg/3000ml)on reducing blood loss and stabilizing circulation during thransurethral resection of the prostate (TURP),in order to reduce the morbidity rate of TURP syndrome and blood loss in clinical practice.Methods: The patients who were to undergo TURP and continuous spine and epduran anesthesia(CSEA) were eligible and enrolled in the period of November 2010 to April 2011,in the First Affiliated Hospital of Dalian Medical University. 19 patients were randomly assigned to two groups, group 1(irrigation fluid contain phenylephrine, n=9) and group 2(irrigation fluid not contain phenylephrine, n=10).In the meantime, we collected 10 patients (group 3) who underwent CSEA. All patients, aged 30-82 years old with cardiac function 2-3 degree according to New York Heart Association (NYHA) ,fulfilled following criteria: no history of severe heart disease, no severe disorders of lung,liver,kidney,skeletal muscle and immune system. Observe SBP,DBP,HR,SpO₂,CO,SV,TFC,ACI,SVR in baseline,after CSEA,after surgery start 5 min,10min,15min,30min,at the end of surgery,and analyse electrolyte, blood routine examination in baseline,after surgery start 10 min,in the end of surgery. At the same time,record irrigation fluid use level,output and analyse the RBC of the irrigation fluid.Results: Hemodynamic markers during operation: all three groups SBP were significantly lower compared to baseline (p≤0.05) at same time points. Group 1 SV and CO were significantly lower compared to baseline (p≤0.05) at same time points. Group 2 ACI was significantly lower compared to baseline (p≤0.05) at same time points. No significant differences were observed for the other hemodynamic parameters. Blood analysis: Na was no significant difference compared to baseline. RBC,HB,Hct were significantly lower compared to baseline (p≤0.05) at T3,T6. Blood loss: the blood loss and average blood loss rate of group 2 were significantly higher (p≤0.05) compared to group 1.Conclusions: choice of irrigation fluid containing phenylephrine (6mg/3000ml) reduce blood loss and irrigation fluid absorbtion.