Effect of osmolality of the irrigation fluid on water intoxication during transurethral resection of the prostate
Takenaka, T.; Nomiyama, S.; Miyoshi, S.; Ooki, H.; Murakami, M.; Tanaka, R.
Masui. Japanese Journal of Anesthesiology 35(11): 1722-1726
1986
ISSN/ISBN: 0021-4892 PMID: 3820563 Document Number: 268244
Intraoperative irrigation of the surgical field often causes water intoxication during transurethral resection procedure. The osmolality of the irrigation fluid is adjusted by its content. Authors studied the effect of irrigation fluid of two different osmolalities; 392 mOsm/L (high group) and 170 mOsm/L (low group). Blood pressure, heart rate, CVP, serum electrolyte, plasma osmotic pressure showed no difference between the two groups during the procedure. Intraoperative sodium ion replacement was required significantly more in the high group. In conclusion, water intoxication is more likely caused by direct inflow of the irrigating solution into vascular space through the sinus exposed by resection. Osmotic pressure of the irrigation solution had less contribution to this complication.