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Monitoring of fluid absorption with nitrous oxide during transurethral resection of the prostate.

Drobin, D ; Hjelmqvist, H ; Piros, D LU and Hahn, R G (2008) In Acta Anaesthesiologica Scandinavica 52(4). p.509-513
Abstract (Swedish)
Background: The fluid absorption that occurs during transurethral resection of the prostate (TURP) can be indicated and quantified by the ethanol method. Recently, nitrous oxide (N(2)O) was tested in animals and volunteers and seemed to be more accurate and safe. The present study compared these two methods in surgical patients.

Methods: Eighty-six TURPs were performed at two hospitals using an irrigating fluid that contained 3% mannitol, 1% ethanol and 0.004% N(2)O (40 ml/l). The ethanol concentration was measured by end-expiratory tests every 10 min. The N(2)O concentration was measured by a flared nasal cannula every second. Fluid absorption was calculated based on a regression equation (ethanol method) from the area under the... (More)
Background: The fluid absorption that occurs during transurethral resection of the prostate (TURP) can be indicated and quantified by the ethanol method. Recently, nitrous oxide (N(2)O) was tested in animals and volunteers and seemed to be more accurate and safe. The present study compared these two methods in surgical patients.

Methods: Eighty-six TURPs were performed at two hospitals using an irrigating fluid that contained 3% mannitol, 1% ethanol and 0.004% N(2)O (40 ml/l). The ethanol concentration was measured by end-expiratory tests every 10 min. The N(2)O concentration was measured by a flared nasal cannula every second. Fluid absorption was calculated based on a regression equation (ethanol method) from the area under the curve based on the samples where CO(2) >median (N(2)O method).

Results: Thirteen patients (15%) absorbed >300 ml of fluid as indicated by the ethanol method. The median volume was 707 ml (range 367-1422). Ethanol yielded higher figures for fluid absorption up to 700-800 ml, whereafter the N(2)O method indicated that the absorption was larger. Over the entire range, the mean difference between the two methods at the end of any 10-min period of TURP was only +45 ml, although the 95% limits of agreement were quite separated (-479 to +569 ml).

Conclusions: The N(2)O method does not require forced breath sampling and was successfully apply clinically. However, there was a dose-dependent difference in result between the ethanol and N(2)O methods, which markedly separated the limits of agreement for a wider range of fluid absorption events. (Less)
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author
; ; and
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Anaesthesiologica Scandinavica
volume
52
issue
4
pages
509 - 513
publisher
Wiley-Blackwell
external identifiers
  • scopus:40849137944
ISSN
0001-5172
DOI
10.1111/j.1399-6576.2007.01572.x
language
Swedish
LU publication?
no
id
67731ce1-b335-4eb0-8eee-fcc3f256abd5
date added to LUP
2022-03-15 16:47:27
date last changed
2022-03-16 05:08:18
@article{67731ce1-b335-4eb0-8eee-fcc3f256abd5,
  abstract     = {{Background: The fluid absorption that occurs during transurethral resection of the prostate (TURP) can be indicated and quantified by the ethanol method. Recently, nitrous oxide (N(2)O) was tested in animals and volunteers and seemed to be more accurate and safe. The present study compared these two methods in surgical patients.<br/><br/>Methods: Eighty-six TURPs were performed at two hospitals using an irrigating fluid that contained 3% mannitol, 1% ethanol and 0.004% N(2)O (40 ml/l). The ethanol concentration was measured by end-expiratory tests every 10 min. The N(2)O concentration was measured by a flared nasal cannula every second. Fluid absorption was calculated based on a regression equation (ethanol method) from the area under the curve based on the samples where CO(2) &gt;median (N(2)O method).<br/><br/>Results: Thirteen patients (15%) absorbed &gt;300 ml of fluid as indicated by the ethanol method. The median volume was 707 ml (range 367-1422). Ethanol yielded higher figures for fluid absorption up to 700-800 ml, whereafter the N(2)O method indicated that the absorption was larger. Over the entire range, the mean difference between the two methods at the end of any 10-min period of TURP was only +45 ml, although the 95% limits of agreement were quite separated (-479 to +569 ml).<br/><br/>Conclusions: The N(2)O method does not require forced breath sampling and was successfully apply clinically. However, there was a dose-dependent difference in result between the ethanol and N(2)O methods, which markedly separated the limits of agreement for a wider range of fluid absorption events.}},
  author       = {{Drobin, D and Hjelmqvist, H and Piros, D and Hahn, R G}},
  issn         = {{0001-5172}},
  language     = {{swe}},
  number       = {{4}},
  pages        = {{509--513}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Anaesthesiologica Scandinavica}},
  title        = {{Monitoring of fluid absorption with nitrous oxide during transurethral resection of the prostate.}},
  url          = {{http://dx.doi.org/10.1111/j.1399-6576.2007.01572.x}},
  doi          = {{10.1111/j.1399-6576.2007.01572.x}},
  volume       = {{52}},
  year         = {{2008}},
}