TRANSURETHRAL RESECTION SYNDROME - EFFECT OF THE INTRODUCTION INTO CLINICAL-PRACTICE OF A NEW METHOD FOR MONITORING FLUID ABSORPTION

Study Objective: To determine the effects of introduction of a new mon itoring system for fluid absorption during transurethral resection of the prostate (TURP) using an irrigating solution containing 0.5% alcoh ol. Study design: Prospective clinical investigation, with implementat ion of statistical process control. Setting: Inpatients for TURF at a major non-university teaching hospital. Patients: 312 male ASA physica l status I, II, III, and IV patients scheduled for TURP. Interventions : Intraoperative breath alcohol levels were measured for detection of fluid absorption. Measurements and Main Results: Calculation of the am ount of fluid absorbed using measured breath alcohol values. Process v ariability (i.e., numbers of patients with significant fluid absorptio n) was defined by statistical process control tools. No trend change o f prevalence of fluid absorption was noted until 150 procedures had be en completed. Reduction of prevalence of significant fluid absorption was noted and no patients were treated postoperatively in the intensiv e care unit. No relevant side effects were seen in patients with signi ficant fluid absorption. No mortality and no severe clinical morbidity was seen after the introduction of the new monitoring. Conclusion: Us ing an irrigating fluid marked with 0.5 % ethanol resulted in a decrea sed prevalence of fluid absorption over time. (C) 1998 by Elsevier Sci ence Inc.