Department of Urology, Hospital General de México, O.D. Dr. Balmis 148 Col. Doctores Del. Cuauhtémoc, México, DF, México.
Int Urol Nephrol. 2012 Apr;44(2):365-9. doi: 10.1007/s11255-011-0071-2. Epub 2011 Oct 16.
To determine whether the use of intraprostatic epinephrine during transurethral resection of the prostate reduces intraoperative blood loss.
A random, double-blind, prospective study was carried out on twenty-three patients that underwent transurethral resection of the prostate. Patients were divided into two groups: (1) group receiving intraoperative intraprostatic injection of epinephrine (thirteen patients) and (2) group receiving intraoperative intraprostatic injection of saline solution as placebo (ten patients). Blood loss was quantified with the following formula: irrigation solution hemoglobin × 1000/intraoperative presurgical serum hemoglobin. The variables analyzed were blood loss, resection time, presurgical prostate volume, and grams of resected tissue. Student´s t test and Pearson correlation were used for their analysis.
There were thirteen patients in the epinephrine group and ten patients in the placebo group. Mean blood loss in the epinephrine group was significantly lower than in the placebo group (127.48 mL ± 77.0 mL vs. 336.63 ± 185.6 mL, 95% CI, 45-234, P < 0.001). There were no statistically significant differences in mean resected grams or mean resection time between the two groups. One patient in the epinephrine group presented with intraoperative hypertensive crisis (7.7%).
Intraprostatic epinephrine injection can be used to reduce blood loss during transurethral resection of the prostate in selected patients. Cardiovascular monitoring should be carried out during its application. Resection time and grams of resected tissue continue to be the most influential factors in relation to blood loss in patients undergoing this treatment modality.
确定经尿道前列腺切除术（TURP）中前列腺内注射肾上腺素是否能减少术中失血量。
对 23 例行 TURP 的患者进行了一项随机、双盲、前瞻性研究。患者分为两组：（1）术中前列腺内注射肾上腺素组（13 例）和（2）术中前列腺内注射生理盐水作为安慰剂组（10 例）。采用以下公式计算失血量：冲洗液血红蛋白×1000/术中术前血清血红蛋白。分析的变量包括失血量、切除时间、术前前列腺体积和切除组织的克数。采用 Student's t 检验和 Pearson 相关性进行分析。
肾上腺素组有 13 例患者，安慰剂组有 10 例患者。肾上腺素组的平均失血量明显低于安慰剂组（127.48±77.0 mL vs. 336.63±185.6 mL，95%CI，45-234，P<0.001）。两组的平均切除克数或平均切除时间无统计学差异。肾上腺素组有 1 例患者术中出现高血压危象（7.7%）。
在选择的患者中，前列腺内注射肾上腺素可减少 TURP 中的失血量。应用时应进行心血管监测。对于接受这种治疗方式的患者，切除时间和切除组织的克数仍然是与失血量最相关的因素。
