Open AccessAre There Acid Base Changes During Transurethral Resection of the Prostate (TURP)?
Author(s) -
Stefan Scheingraber,
L. Heitmann,
Werner Weber,
U Finsterer
Publication year - 2000
Publication title -
anesthesia and analgesia/anesthesia and analgesia
Language(s) - English
Resource type - Journals
eISSN - 1526-7598
pISSN - 0003-2999
DOI - 10.1097/00000539-200004000-00031
Subject(s) - transurethral resection of the prostate , metabolic acidosis , medicine , acidosis , bicarbonate , base excess , prostate , prostatectomy , acid–base imbalance , sodium bicarbonate , urology , acid–base homeostasis , absorption (acoustics) , anion gap , acid–base reaction , anesthesia , endocrinology , chemistry , physics , organic chemistry , cancer , acoustics
Acid base status during transurethral resection of the prostate (TURP) has been almost neglected. We therefore measured the acid base status and interpreted the observed changes according to the Stewart approach. The Stewart model focuses more on the influence of serum electrolyte concentrations on acid base changes than does the conventional Henderson-Hasselbalch approach. In 20 patients undergoing TURP, the following variables were determined: PaO(2), PaCO(2), pH(a), actual bicarbonate, standard base excess, serum concentration of sodium, potassium, chloride, lactate, and total protein. A study group (n = 11) and a control group (n = 9) were built, depending on the maximal amount of fluid absorption estimated with the aid of ethanol concentration monitoring in the expired gas. The study group developed a mild acidosis with a decrease in pH from 7.41 to 7.37 (P = 0.037), compared with a very discrete pH decrease from 7.44 to 7.42 in the control group. We found that moderate irrigant absorption during TURP leads to a specific metabolic acidosis. We speculate that larger amounts of irrigant absorption may cause a more severe metabolic acidosis. As the constellation of independently pH regulating variables appears to be typical for TURP, this acidosis could be named "TURP-acidosis."