[Continuous breath alcohol analysis. Monitoring of irrigation absorption syndrome in transurethral prostate resection]. 1995

A Scherhag, and D Elich, and W Heinrichs
Klinik für Anästhesiologie der Johannes Gutenberg-Universität, Mainz.

The absorption of large volumes of irrigation fluid is a major problem in transurethral prostatic surgery (TUR-P). Various indicators have been tested to monitor fluid absorption with regard to continuous registration and sufficient accuracy. The volumetric fluid balance is not suitable as a routine method because of its inaccuracy. Easily accessible parameters are unspecific because of surgical bleeding (haematocrit [Hct]), or are interfered with by physiological counter-regulatory actions (serum sodium [Na] concentration). In 1986 Hulten et al. suggested adding 2% ethanol to the irrigation fluid as a marker and investigated it intermittently in the expired air with an alcohol-test appliance. In a prospective clinical study of 17 patients undergoing TUR-P under spinal anaesthesia, expiratory concentrations of alcohol that was added to the irrigation fluid (2% ethanol in Purisole, Fresenius, Bad Homburg) were monitored. Gas was continuously sampled from the nasopharynx through a nasal cannula and the ethanol concentration was measured using a modified diverting anaesthetic gas monitor (Normac, Datex, Helsinki) that allows continuous as well as early detection of the absorbed irrigation fluid with reliable accuracy for clinical use. In addition, at intervals of 10 minutes we measured blood alcohol, end-tidal alcohol (Alcotest 7110, Dräger, Lübeck), haematocrit, serum Na concentration, and blood gases. Sixty-eight measurements were obtained from the 17 patients. As shown in other studies, serum Na (r2 = 0.68) and Hct (r2 = 0.39) correlated poorly with the irrigation fluid as determined by serum alcohol levels. In contrast, the expiratory alcohol measurements with the Alcotest 7110 (r2 = 0.93) and Normac devices (r2 = 0.85) were closely related. Continuous monitoring of the expiratory alcohol concentration with a Normac monitor closely reflects blood alcohol concentration, and may hence serve as a useful semiquantitative monitor of irrigation fluid absorption during TUR-P.

UI MeSH Term Description Entries
D007507 Therapeutic Irrigation The washing of a body cavity or surface by flowing water or solution for therapy or diagnosis. Douching,Lavage,Douchings,Irrigation, Therapeutic,Irrigations, Therapeutic,Lavages,Therapeutic Irrigations
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011468 Prostatectomy Complete or partial surgical removal of the prostate. Three primary approaches are commonly employed: suprapubic - removal through an incision above the pubis and through the urinary bladder; retropubic - as for suprapubic but without entering the urinary bladder; and transurethral (TRANSURETHRAL RESECTION OF PROSTATE). Prostatectomy, Retropubic,Prostatectomy, Suprapubic,Prostatectomies,Prostatectomies, Retropubic,Prostatectomies, Suprapubic,Retropubic Prostatectomies,Retropubic Prostatectomy,Suprapubic Prostatectomies,Suprapubic Prostatectomy
D001944 Breath Tests Any tests done on exhaled air. Breathalyzer Tests,Breath Test,Breathalyzer Test,Test, Breath,Test, Breathalyzer,Tests, Breath,Tests, Breathalyzer
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000042 Absorption The physical or physiological processes by which substances, tissue, cells, etc. take up or take in other substances or energy.
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000431 Ethanol A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in ALCOHOLIC BEVERAGES. Alcohol, Ethyl,Absolute Alcohol,Grain Alcohol,Alcohol, Absolute,Alcohol, Grain,Ethyl Alcohol

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