ESRA Academy. Kim Y. Sep 8, 2016; 138454; 0309 Topic: TUR Bladder / Prostate

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Background and Aims:

 The aim of the present study was to compare and to find optimal regional anesthesia technique for Holmium laser eneucleation of the prostate (HoLEP), is being paid attention for alternative to transurethral resection of the prostate.


Sixty nine patients with American Society of Anesthesiologists scores of I-III were randomly allocated into three groups. Patients in group E were received epidural block with 75mg of bupivacaine plus 50ug of fentanyl. In group S, 15mg of bupivacaine and 50ug fentanyl were used for spinal anesthesia. In group SA, patients were received saddle block with 15mg of bupivacaine and 50ug of fentanyl. Systolic blood pressure (SBP), heart rate (HR), time to block of thoracic(T)-10 dermatome, maximal sensorial block time, sensorial block regression time, and side effect were recorded.


Time to maximal level was longest in group E (p<0.05), and maximal sensorial block level was lowest in group SA (p<0.05). Between group E and SA, there was difference in regression time (p<0.05). In group E, group S, and group SA, there was a significant decrease in SBP and HR relative to baseline after the anesthesia. However, there was no statistically diffierence between the groups. In group E, 3 cases of hypotension and 3 cases of bradycardia were observed, and 2 cases of bradycardia was seen in group S and SA.


All three anesthetic techniques may be used safely and are appropriate for HoLEP. However, saddle block may be preferable in HoLEP because we achieve an adquate sensorial level with less side effect.

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