Anesthesia for Urological Surgery

Abstract

Because of the variable techniques and patients' positions used in urological surgery, anesthesia for urologic surgery requires advanced knowledge and special transactions. In this mater, it is important to follow current approaches for anesthesiologists. Diferent surgical procedures and complications due to diferent positions or anesthesia were evaluated separately to be more concise. We have researched recent literature and created this chapter about new technologies in urological surgery and development in anesthesia for urological surgery.Keywords: urological anesthesia, anesthesia management, anesthesia complications, urological surgery complications IntroductionAnesthesia for urological surgery includes unique distinctive diferences, as in all other surgical departments. Therefore, anesthesia for urological surgery requires featured training and experience.To reduce the risk of complications in urological surgery, like all other kinds of surgery, regional anesthesia techniques came to prominence with the help of technological developments. For many urological ventures, only neuraxial blockade application could be enough. This also results in decreased complication risks. In surgeries that must be done with general anesthesia, epidural anesthesia can be used for the maintenance of anesthesia or in the postoperative period. In this way, the rate of intraoperative complications can be reduced and patients' comfort can be increased by providing postoperative pain control and also duration of hospital stay can be reduced [1].© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.During the urological surgery, diferent complications can develop depending on surgical techniques used. For example, most of urological ventures require lots of irrigation luids. In this venture, use of unheated irrigation luid can lead to complications such as hypothermia, delayed recovery from anesthesia and tremor [2].In addition to neuraxial blockade, the use of peripheral blockade has gained importance in urological surgery. For example, obturator blockade application for lateral wall localized bladder cancer could reduce intraoperative complications and increased cancer-free survival [3,4]. Anesthesia for kidney and upper urinary tract surgery Oncological surgery of kidney and upper urinary tract Radical and partial nephrectomyRenal cell carcinoma (RCC) is the ninth common cancer in the USA. According to the SEER database analysis, it is estimated that there will be 62,700 new cases and 14,240 people will die because of this disease. The incidence of kidney and renal pelvis cancer was 15.6 per 100,000 in the USA between 2009 and 2013 [5]. All around the world, radical or partial nephrectomy is accepted curative treatment for kidney tumors. Partial nephrectomy can be performed depending...

Outcomes following inguinal and subinguinal urologic procedures under deep intravenous sedation

“…3,6 Still, GA and SA have been the anesthesia of choice for inguinal and subinguinal procedures as they can both effectively accommodate the perioperative stretch of the spermatic cord, which can elicit a vagal reflex with ensuing bradycardia and pain for the patient. 16 Multimodal anesthetic approaches have long been used for open inguinal hernia repairs, eliciting similar spermatic cord stimulation to the procedures investigated in our study, with minimal complications. 17 A previously published pilot study demonstrated that deploying a multimodal LA approach in combination with DIVS, during inguinal approach, reduced any pain experienced by the patient following spermatic cord stimulation, with the benefit of retrograde amnesia.…”

Low Dose Combined Spinal-Epidural (CSE) Anaesthesia with Blocks for Management of A High-Risk Geriatric Patient with Dilated Cardiomyopathy Posted for TURBT

“…Hemodynamic stability is important in geriatric patients with reduced cardiovascular reserve. Perioperative management of such patients requires preoperative evaluation, risk stratification, perioperative monitoring, maintaining hemodynamic stability, and aims to provide adequate analgesia and early ambulation post-surgery [7]. Combined low-dose spinal anaesthesia plus epidural anaesthesia has better safety profile in patients with low cardiovascular reserve due to better hemodynamic stability.…”

Intravenous Magnesium Sulfate versus Tramadol in Prevention of Post Spinal Shivering in Geriatric Patients Undergoing Transurethral Resection of Prostate

“…Injury to the urethra, bladder, and rectum may occur during the procedure. As a result, shivering not only prolongs the operation time, it may also cause severe complications (5) .…”