Abstract

HoLEP(Holmium Laser Enucleation Of Prostate) surgery has lower morbidity due to a lower transfusion rate and lesser risk of dilutional hyponatremia; nevertheless, the disadvantages are attributed to a longer procedure time and a steep learning curve. The anesthetic aspects of HoLEP have not yet been fully established. The majority of published studies concentrated on HoLEP's urological features. The aim of the current study was to assess different regional anesthesia techniques for HoLEP surgery and to identify the most effective regional anesthesia technique. Material and methods: Following approval from Institutional Ethics Committee (IES-SSMC-0145), a prospective, randomized, comparative study was conducted. The study included 45 patients who were scheduled for HoLEP. Patients who had severe systemic infections or local infections at the injection site, coagulopathy, serious disorders of the central nervous system or peripheral nerves, and history of allergies to local anesthetics, were excluded from the study. Patients (n=15) were randomly assigned to one of three groups (epidural block, spinal block, or saddle block) using the sealed envelope method. Result : Time to T10 dermatome block (P=.024) and time to maximal sensory level block (P=.003) were statistically different between groups A and B. The maximal sensory block level was comparable between groups B and C but higher between groups A and C. The time to 2-segment sensory regression differed statistically substantially between groups and was significantly longer in group A than in group C (P=.007). Conclusion: we conclude that saddle block has a quicker onset, more effective sensory block, and faster recovery in HoLEP surgery

Description

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