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Plasma lignocaine levels during transurethral prostatectomy
I Eardley1, G D Broome, A Murray
1Department of Urology, St Bartholomew's Hospital, London.
Annals of the Royal College of Surgeons of England
|September 1, 1989
Summary
Transurethral lignocaine gel for prostatectomy showed low serum levels, even with additional anesthesia. This study confirms 400 mg lignocaine gel is safe for transurethral procedures, avoiding systemic toxicity.
Area of Science:
- Anesthesiology
- Urology
Background:
- Transurethral absorption of lignocaine can lead to systemic toxicity, particularly with urethral mucosal damage.
- Assessing lignocaine plasma levels is crucial for patient safety during urological procedures.
Purpose of the Study:
- To measure serum lignocaine levels after transurethral administration of 400 mg lignocaine gel before transurethral prostatectomy.
- To evaluate the safety of lignocaine gel in patients undergoing transurethral procedures, with or without additional lignocaine.
Main Methods:
- Serum lignocaine concentrations were measured in 30 patients undergoing transurethral prostatectomy.
- Patients were divided into two groups: Group A (additional lignocaine for anesthesia) and Group B (no additional lignocaine).
- Some patients in both groups also underwent Otis urethrotomy.
Main Results:
- Mean peak plasma lignocaine concentration was 1424 ng/ml in Group A and 72 ng/ml in Group B.
- Plasma concentrations in both groups remained well below established toxic levels.
- No systemic toxicity was reported in relation to lignocaine levels.
Conclusions:
- 400 mg lignocaine gel administered endourethrally before transurethral resection of the prostate results in plasma concentrations significantly below toxic levels.
- The use of lignocaine gel in this context is considered safe, even when additional lignocaine is administered for anesthesia.
- This finding supports the safe application of lignocaine gel in urological surgery.