Incidence, clinical manifestations and outcome of TUR (transurethral resection) syndrome in patients undergoing TURP under spinal anaesthesia: results from clinical observations in a cohort of 50 patients at a tertiary care centre in North India

Abstract

Background: ‘TUR syndrome’ is clinically detectable in 2% of patients undergoing an otherwise safe operation. Currently, spinal anaesthesia is the most widely anaesthetic technique for TURP as it is easier to detect signs of TUR syndrome in an awake patient. This study aimed at looking at the clinical spectrum and outcomes of TUR syndrome in patients undergoing TURP under spinal anaesthesia.Methods: This clinical study was conducted over a period of 6 months in the departments of anesthesiology and urology at the Christian medical college and hospital Ludhiana in a cohort of 50 male patients electively admitted for TURP under spinal block belonging to ASA I or II groups. Patients received intermittent irrigation with 1.5% glycine, and monitored for TUR symptoms and electrolyte estimations perioperatively.Results: In our study the incidence of TURP syndrome was 10 %. Under spinal block clinical manifestations along with serum sodium values monitored perioperatively helped diagnose and manage the patients. All patients successfully completed resection, with no mortality related to TURP syndrome.Conclusions: In patients undergoing transurethral resection of prostate under spinal anaesthesia, monitoring clinical symptoms for the rare TURP syndrome and additional serum sodium levels act as an adjunct in diagnosis. In both situations diagnosis and early intervention prevents extreme neurological symptoms and reduces mortality.