Dilutional Hypervolemia During Transurethral Resection of the Prostate

Absorption of large amounts of isotonic irrigating solution has been reported in patients undergoing transurethral resection of the prostate under regional anesthesia. Arterial hypertension accompanied by slowing of the pulse and mental agitation has been found pathognomonic. With the advent of newer and safer nonexplosive inhalation agents, more electro-resections are performed under general anesthesia. The hospital course of three patients with excessive fluid absorption occurring under inhalation anesthesia is described. The signs of restlessness, nausea, and disorientation are not seen in an unconscious patient. Dyspnea and cyanosis may be delayed by better oxygenation and assisted ventilation. The only signs remaining under general anesthesia are increasing systolic and diastolic pressures, widening pulse pressure and little change in pulse rate.