Transurethral resection syndrome: Effect of the introduction into clinical practice of a new method for monitoring fluid absorption

Study Objective: To determine the effects of introduction of a new monitoring system for fluid absorption during transurethral resection of the prostate (TURP) using an irrigating solution containing 0.5% alcohol. Study design: Prospective clinical investigation, with implementation of statistical process control. Setting: Inpatients for TURF at a major non-university teaching hospital. Patients: 312 male ASA physical status I, II, III, and IV patients scheduled for TURP. Interventions: Intraoperative breath alcohol levels were measured for detection of fluid absorption. Measurements and Main Results: Calculation of the amount of fluid absorbed using measured breath alcohol values. Process variability (i.e., numbers of patients with significant fluid absorption) was defined by statistical process control tools. No trend change of prevalence of fluid absorption was noted until 150 procedures had been completed. Reduction of prevalence of significant fluid absorption was noted and no patients were treated postoperatively in the intensive care unit. No relevant side effects were seen in patients with significant fluid absorption. No mortality and no severe clinical morbidity was seen after the introduction of the new monitoring. Conclusion: Using an irrigating fluid marked with 0.5 % ethanol resulted in a decreased prevalence of fluid absorption over time. (C) 1998 by Elsevier Science Inc.