Get a printable copy (PDF file) of the complete article (1.3M), or click on a page image below to browse page by page. Full textįull text is available as a scanned copy of the original print version. These responses may be related to the rapid central cooling observed during transurethral prostatectomy and require further study.

CONCLUSIONS-Important haemodynamic disturbances were identified during routine apparently uneventful transurethral prostatectomy but not during control procedures. Significant differences existed between the two groups in summary measures of mean arterial pressure (p less than 0.05), Doppler indices of stroke volume (p less than 0.005) and cardiac output (p less than 0.005), index of systemic vascular resistance (p less than 0.0005), and core temperature (p less than 0.0001). Core temperature fell by a mean of 0.8 (-1.0 to -0.6) degrees C. The index of systemic vascular resistance was increased by 28% (17% to 38%) at two minutes, and by 46.8% (28% to 66%) at the end of the procedure. Doppler indices of stroke volume fell progressively to 15% (-24% to -6%) below baseline at the end of the procedure, and the index of cardiac output fell to 21% (-32% to -10%) below baseline by the end of the procedure. Bradycardia reached -7% (-14% to 1%) by the end of the procedure.

During transurethral prostatectomy mean arterial pressure increased by 16% (5% to 27%) at the two minute recording and remained raised throughout.

RESULTS-In the control group mean arterial pressure fell to 11% (95% confidence interval -17% to -5%) below baseline at two minutes into surgery and remained below baseline there were no other overall changes in haemodynamic variables and the core temperature was stable. MAIN OUTCOME MEASURES-Percentage change from baseline in mean arterial pressure, heart rate, Doppler indices of stroke volume and cardiac output, and index of systemic vascular resistance, and change from baseline in core temperature. PATIENTS-33 men aged 50-85 years in American Society of Anesthesiologists risk groups I and II undergoing transurethral prostatectomy (20), herniorrhaphy (eight), or testicular exploration (five). OBJECTIVE-To compare haemodynamic performance during transurethral prostatectomy and non-endoscopic control procedures similar in duration and surgical trauma.

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