Key result
Saddle block significantly reduced the incidence of hypotension and the need for vasopressors compared to spinal anesthesia during transurethral resection of the prostate (0% vs 48%, p<0.001).
Why the study?
Hypotension is the major complication following spinal anesthesia for TURP, and hemodynamic changes may be less pronounced with saddle block.
Does saddle block reduce hypotension and improve hemodynamic stability compared to spinal anesthesia in patients undergoing transurethral resection of the prostate?
RCT (n=50)
Randomized
Yes
Does saddle block reduce hypotension and improve hemodynamic stability compared to spinal anesthesia in patients undergoing transurethral resection of the prostate?
Absolute Event Rate: 0% vs 48%
p-value: p=<0.001
Saddle block provides better hemodynamic stability with a lower risk of hypotension and reduced need for vasopressors compared to spinal anesthesia during transurethral resection of the prostate.
Saddle block may be preferred over spinal anesthesia in TURP to limit hypotension; extends RCT evidence supporting its hemodynamic advantage.
Background: The best technique for transurethral resection of prostate (TURP) is regional anesthesia. The hypotension is the major complication following spinal anesthesia. The hemodynamic changes is less with saddle block than spinal block. Aim and Objective: To compare hemodynamic effect between the spinal block and saddle block in TURP. Patients and methods: 50 patients between 50-70 years old ASA I – II prepared for TURP, divided randomly in two groups 25 pt. in each group. Group A received spinal 10 mg of hyperbaric bupivacaine (2 ml of 0.5%), were group B received saddle block 10 mg of hyperbaric bupivacaine (2 ml of 0.5%). The blood pressure, oxygen saturation, heart rate measured and recorded subsequently. The hypotension treated by 100 mcg bolus of phenylephrine. Results: In our study there was statically significant difference (p < 0.05) between group A which received spinal anesthesia and group B which received saddle block in hemodynamic effect. In which the incidence of hypotension and vasopressor requirement more in group A. Conclusion: Under saddle block the TURP can safely performed with low risk of hypotension and less requirement of vasopressor.
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Abdulqader et al. (2021) conducted an RCT in Benign prostatic hyperplasia (BPH) requiring TURP (n=50). Saddle block vs. Spinal anesthesia was evaluated on Incidence of hypotension requiring vasopressor (phenylephrine) (p=<0.001). Saddle block significantly reduced the incidence of hypotension and the need for vasopressors compared to spinal anesthesia during transurethral resection of the prostate (0% vs 48%, p<0.001).
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