Anesthesia for radical prostatectomy

Filimonovic, J.; Gvozdić, Branka; Krivic, B.; Acimovic, M.; Tulić, C.; J, Hadzi Djokic

doi:10.2298/aci0504113f

Cited by 4 publications

(1 citation statement)

References 10 publications

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“…Different attempts are made to reduce bleeding. Improvement of anesthetic techniques and use of new anesthetic agents contribute to better outcome of RP (2)(3)(4). Regional anesthetic techniques may reduce this risk.…”

Section: Introductionmentioning

confidence: 99%

Epidural and general anesthesia versus general anesthesia in radical prostatectomy

et al. 2009

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Induced hypotension with epidural anesthesia influences the intraoperative blood loss in prostate cancer patients undergoing radical prostatectomy. The aim of this study was to evaluate intraoperative blood loss and need of blood transfusions in patients who underwent radical prostatectomy under epidural/general anesthesia and general anesthesia. Two groups were selected: epidural/general anesthesia group (study group, 27 patients) received epidural anesthesia in association with general anesthesia, and general anesthesia group (control group, 27 patients) received general anesthesia alone. Epidural/general anesthesia was performed using 0.5% solution of bupivacaine and maintained by volatile anesthetic sevoflurane. General anesthesia was performed with endotracheal ventilation using sevoflurane and intravenous fentanyl. The present study showed that the mean blood loss in epidural/general anesthesia group was significantly lower in comparison with that of general anesthesia group (740±210 mL versus 1150±290 mL, P<0.001). In addition, less allogeneic blood was transfused in epidural/general anesthesia group: 0.19 blood units transfused versus 0.52 blood units in general anesthesia group (P=0.007). Our study proved that induced hypotension with epidural/general anesthesia reduced intraoperative blood loss and need of allogeneic blood transfusions in cancer patient undergoing open radical prostatectomy.

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Section: Introductionmentioning

confidence: 99%

Epidural and general anesthesia versus general anesthesia in radical prostatectomy

et al. 2009

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30 Years Lost in Anesthesia Theory

Coleman¹

2012

CHAMC

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The recent discovery of the "Stress Repair Mechanism" (SRM) enables the Unified Theory of Medicine postulated by Hans Selye. It confers cohesive theories of anesthesia, analgesia, and allostasis that enable the alteration of anesthetic technique to optimize surgical outcome. The SRM continuously maintains and repairs the vertebrate body in accord with stressful forces and stimuli. Three synergistic pathways activate the SRM: the spinal pathway, the cognitive pathway, and the tissue pathway. Emotional mechanisms modulate the cognitive pathway, which explains allostasis. Surgery simultaneously stimulates all three synergistic pathways, causing harmful SRM hyperactivity that manifests as the Surgical Stress Syndrome. Anesthesia inhibits the cognitive pathway. Analgesia inhibits the spinal pathway. Synergistic combinations of anesthesia and analgesia minimize SRM hyperactivity better than either alone. This principle improves outcome, simplifies anesthetic technique, and minimizes polypharmacy and drug toxicity. Once verified, stress theory will advance surgical safety, accelerate recovery, minimize complications, reduce costs, enhance patient comfort, and guide pharmaceutical development to discover treatments that inhibit the tissue pathway, and thereby eliminate surgical stress altogether.

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A Stress Repair Mechanism That Maintains Vertebrate Structure During Stress

Coleman

2010

CHDDT

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Based on Capillary Gate Theory and Tissue Repair Theory, this paper describes the "Stress Repair Mechanism" (SRM) that maintains and repairs vertebrate tissues. It accounts for most of the mysterious manifestations of allostasis that remain unexplained by Hypothalamic-Pituitary-Axis (HPA) hormones and thereby enables the Universal Theory of Medicine predicted by Hans Selye. SRM activity explains hemodynamic physiology, capillary hemostasis, infarction, Korotkoff sounds, blood pressure, hypertension, diabetes, allostasis, allostatic load, anesthesia, analgesia, atherosclerosis, apoptosis, malignancy, eclampsia, sepsis, Multi-System Organ Failure (MSOF), the surgical stress syndrome, the fight or flight response, and numerous other manifestations of physiology and pathology. SRM function comprises the autonomic nervous system, the vascular endothelium, and the dynamic enzymatic interaction of blood-borne hepatic Factors VII, VIIIC, IX and X that produces thrombin, soluble fibrin and insoluble fibrin, whose combined effects account for all SRM manifestations. The vascular endothelium is a diaphanous neuroendocrine organ that lines all blood vessels and is the sole constituent of capillary walls. It secretes tissue factor into extravascular tissues, and insulates those tissues from the hepatic enzymes, so that tissue disruption exposes tissue factor to the enzymatic interaction and activates tissue repair. The vascular endothelium also releases nitric oxide and von Willebrand Factor into blood in accord with autonomic balance to regulate the enzymatic interaction to govern tissue perfusion and organ function. Therefore, continuously fluctuating combinations of nervous stimuli that affect autonomic balance and forces that disrupt tissues determine SRM activity.

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Anesthesia for radical prostatectomy

Cited by 4 publications

References 10 publications

Epidural and general anesthesia versus general anesthesia in radical prostatectomy

Epidural and general anesthesia versus general anesthesia in radical prostatectomy

30 Years Lost in Anesthesia Theory

A Stress Repair Mechanism That Maintains Vertebrate Structure During Stress

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