Transurethral Resection With Subarachnoid Block

Abstract

It has been suggested that spinal anesthesia is the technique of choice for transurethral resection of the prostate. 1,2 Adequate muscular relaxation, analgesia, lack of explosion hazard, moderate drop of blood pressure (resulting in less bleeding), lack of depressant effects of respiratory function, and having an awake patient have been cited as advantages. Peculiar to this urologic procedure are the intermittent bladder distention required for adequate visualization of the operating field and the passage of nonelectrolyte solution from the bladder through the open venous sinuses of the prostatic bed into the venous circulation. 1 Hypotension commonly occurs within 20 minutes of onset of anesthesia. However, we have observed sudden episodes of bradycardia and hypotension occurring in the late phase of transurethral resection with the patient under spinal anesthesia. Two such instances are discussed here. Report of Cases Case 1.— A 73-year-old man was to have transurethral resection of the prostate for