Urological day case surgery in elderly and medically unfit patients using sedoanalgesia: what are the limits?

Briggs, T.; Anson, Ken; Jones, A.P.; Coker, B.J.; Miller, Ronald

doi:10.1111/j.1464-410x.1995.tb07376.x

Cited by 6 publications

(2 citation statements)

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“…Safety, effectiveness and low cost, make sedoanalgesia a preferable alternative to general or spinal anaesthesia for many urological procedures [6] . Moreover, sedoanalgesia should be considered in elderly patients with multiple comorbidities thus minimising morbidity and hastening recovery [3] . It is an ideal form of anaesthesia for day care procedures, as most of the patients will be alert and well oriented in a few hours.…”

Section: Discussionmentioning

confidence: 99%

“…Many patients who undergo surgery for BPH have associated comorbidities and are deemed unfit for general anaesthesia. In such a scenario, sedoanalgesia seems to be a promising option, enabling faster recovery and shorter hospitalisation [3] . Data accumulated over the years have reported favourable results [4] , [5] for both PVP and TURP under sedoanalgesia, with excellent intraoperative safety and expedient postoperative recovery.…”

Section: Introductionmentioning

confidence: 99%

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Day care bipolar transurethral resection vs photoselective vaporisation under sedoanalgesia: A prospective, randomised study of the management of benign prostatic hyperplasia

Sood

Manasa

Goel

et al. 2017

Arab Journal of Urology

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ObjectiveTo conduct a prospective randomised study comparing the safety, effectiveness and treatment outcomes in patients undergoing bipolar transurethral resection of the prostate (bTURP) and photoselective vaporisation of the prostate (PVP) under sedoanalgesia, as sedoanalgesia is a safe and effective technique suitable for minimally invasive endourological procedures and although studies have confirmed that both TURP and PVP are feasible under sedoanalgesia there are none comparing the two.Patients and methodsBetween November 2014 and April 2016, all patients satisfying the eligibility criteria underwent either bTURP or PVP under sedoanalgesia after randomisation. The groups were compared for functional outcomes, visual analogue scale (VAS) pain scores (range 0–10), perioperative variables and complications, with a follow-up of 3 months.ResultsIn all, 42 and 36 patients underwent bTURP and PVP under sedoanalgesia, respectively. The mean VAS pain score was <2 at any time during the procedure, with no conversions to general anaesthesia. PVP patients had a shorter operating time [mean (SD) 55.64 (12.8) vs 61.79 (14.2) min, P = 0.035], shorter duration of hospitalisation [mean (SD) 14.58 (2.81) vs 19.21 (2.82) h, P < 0.001] and a higher dysuria rate when compared to bTURP patients. However, the catheterisation time was similar and both intraoperative and postoperative complications were minimal and comparable. Improvements in the International Prostate Symptom Score, quality of life, prostate volume, maximum urinary flow rate and post-void residual urine volume at 3 months were similar in both groups. None of our patients required re-admission or re-operation.ConclusionBoth PVP and bTURP can be carried out safely under sedoanalgesia with excellent treatment outcomes.

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Section: Discussionmentioning

confidence: 99%