Detection of fluid volume absorption by end-tidal alcohol monitoring in patients undergoing endoscopic renal pelvic surgery

Study Objective: To determine the risk of relevant fluid absorption (calcul ated volume above 500 ml) during endoscopic procedures of the renal pelvis. Design: Prospective clinical investigation with implementation of statistic al process control fools (SPC). Setting: Nonuniversity teaching hospital. Patients: 62 consecutive ASA physical status I and II patients scheduled fo r endoscopic renal pelvic surgery with general anesthesia. Interventions: Intraoperative measurement of breath alcohol for defection o f fluid absorption. Irrigation fluid (0.9 % saline) with 1% alcohol for tra cing the irrigation fluid, Measurements and Main Results: Calculation of the amount of fluid adsorbed using breath alcohol v alues. Process variability (numbers of patients with relevant fluid absorpt ion) defined by SPC. The prevalence of fluid absorption in endoscopic renal pelvic surgery was 6%. Peak fluid absorption during a vascular route war d etected by the monitoring Monitoring was easily introduced into routine cli nical practice. No relevant side effects due to the monitoring were seen in patients with relevant fluid absorption. There was no mortality but two pa tients with detected severe fluid overload wga admitted to the intensive ca re unit for treatment. Conclusion: Breath alcohol levels during general anesthesia for endoscopic renal pelvic surgery were technically simple to measure. Our results show t he predictive value of alcohol monitoring which has been previously demonst rated only for transurethral prostatectomy, The prevalence of relevant flui d adsorption was 6% compared to 13% during transurethral resection of the p rostate. (C) 1999 by Elsevier Science Inc.