Abstract
Induced hypotension with epidural anesthesia influences the intraoperative blood loss in prostate cancer patients undergoing radical prostatectomy. The aim of this study was to evaluate intraoperative blood loss and need of blood transfusions in patients who underwent radical prostatectomy under epidural/general anesthesia and general anesthesia. Two groups were selected: epidural/general anesthesia group (study group, 27 patients) received epidural anesthesia in association with general anesthesia, and general anesthesia group (control group, 27 patients) received general anesthesia alone. Epidural/general anesthesia was performed using 0.5% solution of bupivacaine and maintained by volatile anesthetic sevoflurane. General anesthesia was performed with endotracheal ventilation using sevoflurane and intravenous fentanyl. The present study showed that the mean blood loss in epidural/general anesthesia group was significantly lower in comparison with that of general anesthesia group (740+/-210 mL versus 1150+/-290 mL, P<0.001). In addition, less allogeneic blood was transfused in epidural/general anesthesia group: 0.19 blood units transfused versus 0.52 blood units in general anesthesia group (P=0.007). Our study proved that induced hypotension with epidural/general anesthesia reduced intraoperative blood loss and need of allogeneic blood transfusions in cancer patient undergoing open radical prostatectomy.
Highlights
Open radical prostatectomy (RP) is an effective surgical method in cancer patients
The present study showed that the mean blood loss in epidural/general anesthesia group was significantly lower in comparison with that of general anesthesia group (740±210 mL versus 1150±290 mL, P
Our study proved that induced hypotension with epidural/general anesthesia reduced intraoperative blood loss and need of allogeneic blood transfusions in cancer patient undergoing open radical prostatectomy
Summary
Open radical prostatectomy (RP) is an effective surgical method in cancer patients. This procedure is aggressive and associated with the risk of troublesome intraoperative bleeding from plexuses of the dorsal vein complex. RP is associated with substantial blood loss frequently requiring allogenic blood transfusion. Allogenic blood transfusion has immunomodulatory effects that may increase the risk of nosocomial infections and cancer recurrence, and the possible development of autoimmune diseases later in life [1]. Regional anesthetic techniques may reduce this risk. Spinal/epidural anesthesia combined with general anesthesia is an attractive method to induce hypotension with significantly reduced blood loss and blood transfusions [5,6,7,8]
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