[Anesthesia for transurethral resection of the prostate: comparison between two periods in a university hospital.]

Anesthesia for transurethral resection of the prostate (TURP) has been studied for years due to the uniqueness of the surgical procedure. This study aimed at comparing TURP anesthetic techniques and possible surgical complications in two different time periods with a ten-year interval, to detect evolution of those techniques and decrease in morbidity-mortality rates.

Medical records of all patients submitted to TURP in HC-FMRP-USP in two different 4-year periods were retrospectively evaluated: GI - surgical procedures (TURP) performed between 1989 and 1992; GII - surgical procedures (TURP) performed between 1999 and 2002. Malignant prostate and bladder neoplasias were excluded. A total of 300 medical records were included: 120 in GI and 180 in GII.

Regional anesthesia was predominant in both groups and spinal anesthesia was more frequently used. Mean procedure length was higher in GII and the incidence of intraoperative adverse events such as hypotension, arrhythmias and hypothermia was not statistically different between groups. In the first 24 postoperative hours however, more GI patients had acute myocardial infarction, probably due to lack of preoperative exams and cardiologic evaluation of patients submitted to surgery during this period. Length of stay in post-anesthetic care unit was similar between groups, but complications were more frequent in GI. Blood transfusions and perioperative mortality were not different between groups.

Although there was improvement in anesthetic techniques (new drugs and equipment) and in surgical apparatus after this 10-year interval, decrease in blood transfusions, surgical complications (intra or postoperative) or mortality rates could not be observed in the first 24 postoperative hours.