Key result
Modified saddle block reduces MAP drop by ~65% versus subarachnoid block during prostate resection.
Why the study?
Hemodynamic derangement is often less pronounced in saddle block compared to subarachnoid block during spinal anesthesia for TURP, but comparative data are limited.
Does modified saddle block reduce the fall in MAP and HR compared to subarachnoid block in patients undergoing elective TURP?
RCT (n=120)
randomized
Does modified saddle block reduce the fall in MAP and HR compared to subarachnoid block in patients undergoing elective TURP?
Absolute Event Rate: 3.13% vs 8.98%
p-value: p=<0.001
Modified saddle block provides better hemodynamic stability with less fall in MAP and HR compared to subarachnoid block during TURP.
Modified saddle block may be preferred to minimize instability in elective TURP; extends RCT evidence on optimized spinal techniques for urologic procedures.
BACKGROUND: Spinal anesthesia is often the mode of anesthesia in transurethral resection of prostate (TURP) albeit with risk of hypotension. However, hemodynamic derangement is often less pronounced in saddle block. This study was conducted to compare the mean fall in Mean arterial Pressure (MAP) and Heart rate (HR) between modified saddle block and subarachnoid block for TURP. OBJECTIVE: To compare the mean fall in MAP and HR between modified saddle block and subarachnoid block for TURP. METHODS: In this randomized controlled trial 120 patients undergoing elective TURP were included and divided into two groups. Group A Patients received subarachnoid block and Group B received modified saddle block. Baseline hemodynamics were recorded before and then at 5 minutes after anesthesia. All the collected data was entered into SPSS version 22 and analyzed. Quantitative data like age, BMI, ASA-PS score, duration of surgery and baseline hemodynamics were presented as means and standard deviations. The fall of mean arterial pressure (MAP) & heart rate (HR) were compared among groups by independent t test and P value < 0.05 was considered as statistically significant. RESULTS: Mean fall in MAP was 8.98±1.28 mmHg and 3.13±0.68 mmHg (p<0.001) in group A and B, respectively. Mean fall in HR was 7.17±0.98 and 2.78±0.59 (p<0.001) in group A and group B, respectively. CONCLUSION: Modified saddle block resulted in significantly decreased fall in MAP and HR as compared with subarachnoid block for TURP.
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Anjum et al. (2023) conducted an RCT in Transurethral resection of prostate (TURP) (n=120). Modified saddle block vs. Subarachnoid block was evaluated on Mean fall in Mean Arterial Pressure (MAP) (p=<0.001). Modified saddle block resulted in a significantly smaller mean fall in mean arterial pressure (3.13 vs 8.98 mmHg; p<0.001) compared to subarachnoid block for transurethral resection of prostate.
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