Use of Spinal Anesthesia Does Not Reduce Intraoperative Blood Loss

Wong, Robert P.; Carter, H. Ballentine; Wolfson, Alexander; Faustin, Christopher; Cohen, Seth R.; Wu, Christopher L.

doi:10.1016/j.urology.2007.04.034

Cited by 8 publications

(6 citation statements)

References 22 publications

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“…Venous blood pooling enhances these effects with decreased venous return and cardiac output, with the positive consequence of local hypotension in the surgical field [11]. However there are also published results showing no difference in anesthesia-dependent intraoperative blood loss [8].…”

Section: Discussionmentioning

confidence: 99%

“…For example, it has been shown that spinal and/or epidural anesthesia is feasible and is safely used for radical cystectomy for high risk patients with contraindications for general anesthesia [5]. Other studies indicate that the use of neuraxial anesthesia might be beneficial for reduction of intraoperative blood loss leading to reduced blood transfusion [6–8]. A large retrospective analysis suggests a beneficial effect of regional anesthesia on cancer progression after surgery for prostate cancer [9].…”

Section: Introductionmentioning

confidence: 99%

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Anesthesia for Open Radical Retropubic Prostatectomy: A Comparison between Combined Spinal Epidural Anesthesia and Combined General Epidural Anesthesia

et al. 2019

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Background. Several anesthesiologic regimens can be used for open radical retropubic prostatectomy. The aim of this retrospective analysis was to compare the combined general epidural anesthesia and the combined spinal epidural anesthesia with regard to availability, efficacy, side effects, and perioperative time consumption in a high-volume center. Methods. A retrospective analysis was performed by querying the electronic medical records of 1207 consecutive patients from the database of our online documentation software. All patients underwent open radical retropubic prostatectomy from 01/2008 to 08/2011 and met the study criteria. Linear and multivariate regression analyses were performed to identify differences in parameters such as time consumption in the operating unit, hemodynamic parameters, volume replacement, and catecholamine therapy. Results. 698 (57.8%) patients have been undergoing open radical retropubic prostatectomy under combined spinal epidural anesthesia and 509 (42.2%) patients by combined general epidural anesthesia. Operating unit (p <0.0001) and post-anesthesia care unit stay (p <0.0001) as well as total hospital stay (p <0.0001) were significantly shorter in the combined spinal epidural anesthesia group. In addition, this group had reduced intraoperative volume need (p <0.0001) as well as lower need of catecholamines (p <0.0001). Conclusions. This retrospective study suggests that the combined spinal epidural anesthesia seems to be a suitable and efficient anesthesia technique for patients undergoing open radical retropubic prostatectomy. This specific approach reduces time in the operation unit and length of hospital stay.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anesthesia for Open Radical Retropubic Prostatectomy: A Comparison between Combined Spinal Epidural Anesthesia and Combined General Epidural Anesthesia

et al. 2019

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“…Wong et al [19] compared two groups that underwent radical prostatectomies. They reported that there was no significant intergroup difference, and that blood losses were influenced by surgical skill and surgery time rather than anesthesia types, which presents a great contrast to this study.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, their study could not deal with uterine contraction that influences hemorrhage. In this study, factors presented by Wong et al [19] were taken into consideration to specifically to minimize variables in surgical skill and surgery time, and this study was limited to c-sec performed by two obstetricians having over ten years' experience.…”

Section: Discussionmentioning

confidence: 99%

The effect of type of anesthesia on intra-and postoperative blood loss at elective cesarean section

Kim

Lee

Kim

et al. 2012

Korean J Anesthesiol

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BackgroundIn cesarean section (c-sec) it is known that women receiving spinal anesthesia have decreased intraoperative blood loss compared to women receiving general anesthesia. However, we should always consider postoperative bleeding (postpartum bleeding) that may follow. The amount of postpartum bleeding can be substantial. Therefore, we sought to evaluate the effect of type of anesthesia retrospectively on intra- and postoperative blood loss by comparing the changes of postoperative Hb, Hct at c-sec.MethodsWe retrospectively compared the medical records of 287 elective c-sec patients. We excluded medical and obstetric conditions that may predispose such patients to increased blood loss. Subsequent detailed record analysis included 152 patients that received spinal anesthesia (group S), and 135 patients that received sevoflurane for general anesthesia (group G).ResultsIn comparison with the preoperative Hb, rates of Hb in the 1st postoperative day in group S significantly decreased compared to group G, but there was no significant difference in decreasing rates of Hb in the 3rd postoperative day between groups S and G. Estimated blood loss (EBL) of the intraoperative and operative day in group S was significantly lower compared to group G, but there was no significant difference in EBL of 1st and 2nd postoperative day between groups S and G.ConclusionsWe conclude that group S had a decrease in blood loss between the intraoperative and operative day and there was no significant differences in postoperative blood loss compared with group G.

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“…Anterior urethral stricture was observed in 2 patients. Most patients were discharged within 5 days from the procedure (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Following an anamnestic assessment conducted two weeks after the operation, we observed a quick recovery of total continence in 90% of patients.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness and safety of spinal anesthesia in patients undergoing open radical retropubic prostatectomy

Blanco

Grasso

Sulmina

et al. 2023

Arch Ital Urol Androl

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Objective: Prostate cancer is one of the most widespread neoplasms affecting the male gender. The most commonly used procedures in various urological centers are laparoscopic and robotic surgery because they are considered minimally invasive techniques. We present our experience in traditional open radical prostatectomy performed under spinal anesthesia. Materials and methods: We reviewed the clinical courses of 88 consecutive patients who underwent open radical prostatectomy performed under spinal anesthesia at our Institution. Results: Median age: 67.7 years. Median follow up duration: 48 months. Median pre-operative PSA: 15,9 ng/ml, median Prostate weight: 44.5 gr, median surgical time: 96.5 minutes (range 55-138). Perioperative complications were recorded. The most frequent complication was anemia, 9 cases need blood transfusion after surgery. Complications directly related to spinal anesthesia were not observed. Most patients were discharged within 5 days from the procedure. After two weeks we observed a quick recovery of total continence in 90% of patients. After 6 months all patients were perfectly continent. Erectile dysfunction after 6 months was reported by 48 patients. Conclusions: The reasons why the gold standard of radical prostatectomy surgery has been considered general anesthesia are essentially two: the long duration of the surgical procedure and the associated significant blood loss. Multiple evidences show that radical retropubic prostatectomy can be safely performed under spinal anaesthesia with various advantages. It is therefore no longer justified to consider general anesthesia as the gold standard for radical prostatectomy with an open technique.

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Use of Spinal Anesthesia Does Not Reduce Intraoperative Blood Loss

Cited by 8 publications

References 22 publications

Anesthesia for Open Radical Retropubic Prostatectomy: A Comparison between Combined Spinal Epidural Anesthesia and Combined General Epidural Anesthesia

Anesthesia for Open Radical Retropubic Prostatectomy: A Comparison between Combined Spinal Epidural Anesthesia and Combined General Epidural Anesthesia

The effect of type of anesthesia on intra-and postoperative blood loss at elective cesarean section

Effectiveness and safety of spinal anesthesia in patients undergoing open radical retropubic prostatectomy

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