INTRAOPERATIVE BLOOD-LOSS DURING RADICAL RETROPUBIC PROSTATECTOMY - EPIDURAL VERSUS GENERAL-ANESTHESIA

Objectives. There are conflicting reports on the influence of differen t anesthetic techniques, such as regional versus general anesthesia, o n intraoperative blood loss. The purpose of this study was to elucidat e the effects of anesthetic technique on intraoperative blood loss in men undergoing radical retropubic prostatectomy (RRP). Methods. One hu ndred patients undergoing RRP for prostate cancer were randomly assign ed to receive either epidural anesthesia (EA), combined epidural and g eneral anesthesia (EG), or general anesthesia alone (GA). Intraoperati ve blood loss was calculated by using a formula that accounted for the volume and hematocrit of the fluid suctioned from the surgical field, blood absorbed on surgical pads, and the patient's hematocrit. Result s. Mean blood loss in the EA group (1490 +/- 90 mL; mean +/- SEM) was significantly less than mean blood loss in both the EG group (1810 +/- 100 mL) and the GA group (1940 +/- 130 mL) (P = 0.01). Blood loss was not different between the EG and the GA groups (P = 0.7). Significant ly less blood was transfused during surgery in the EA group (730 +/- 5 0 mL) compared with the EG (960 +/- 60 mL) and GA (950 +/- 70 mL) grou ps (P = 0.02). Conclusions. Similar blood loss in patients receiving g eneral anesthesia, either alone or when combined with epidural anesthe sia, implies that epidural anesthesia did not reduce bleeding, but, ra ther, that general anesthesia increased blood loss.