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Diuretics after transurethral prostatectomy: a double-blind controlled trial comparing frusemide and mannitol
K Crowley1, K Clarkson, V Hannon
1Department of Anaesthesia & Critical Care Medicine, St Vincent's Hospital, Dublin, Ireland.
British Journal of Anaesthesia
|September 1, 1990
Summary
Mannitol and frusemide offer comparable diuretic effects post-prostatectomy. Mannitol may be a safer alternative, reducing sodium loss and protecting against water intoxication.
Area of Science:
- Nephrology
- Urology
- Pharmacology
Background:
- Post-prostatectomy patients are at risk of fluid and electrolyte imbalances.
- Diuretics are commonly used to manage fluid balance, but carry risks.
- Water intoxication is a potential complication following prostatectomy.
Purpose of the Study:
- To compare the diuretic efficacy of mannitol and frusemide.
- To evaluate the effects of mannitol and frusemide on sodium balance and water intoxication indices.
- To determine the safety and effectiveness of mannitol as an alternative to frusemide in post-prostatectomy patients.
Main Methods:
- Randomized, controlled, double-blind trial comparing mannitol and frusemide.
- Monitoring of diuretic output, sodium loss, and plasma osmolality.
- Assessment of the need for intravenous volume expansion.
Main Results:
- Both mannitol and frusemide demonstrated comparable diuretic effects.
- Frusemide led to greater sodium loss and increased need for fluid resuscitation.
- Mannitol resulted in higher plasma osmolality and sodium concentration, suggesting better protection against water intoxication.
Conclusions:
- Mannitol is an effective diuretic alternative to frusemide after prostatectomy.
- Mannitol may offer a protective effect against water intoxication compared to frusemide.
- Careful monitoring of sodium balance is crucial when using frusemide post-operatively.