Water intoxication from intravascular absorption of non-electrolyte irrigating fluid is a well-known and often serious complication of TURP(transurethral resection of the prostate). The amount of fluid absorbed is related to the time elapsed,
number of
venous sinuses opening during resection and the height of the irrigation container.
A 78-year-old male patient was performed TURP spinal anesthesia. During the operation, chest discomfort, peripheral cyanosis, sinus bradycardia, drowsy mental state, hypoxemia, metabolic acidosis, severe hyponatremia, and pulmonary edema
appeared.
We had made a decision to stop operation immediately and transported to ICU. Endotracheal intubation and controlled mechanical ventilation with positive and expiratory pressure were performed and NaCI 240mEq, NaHCO3 240mEq, furosemide 20mg and
20%
mannitol 200ml were injected for four hours.
There hours and forties minutes after operation, reoperation was done for bleeding control. In consequence of reoperation, the patient began to improve in condition and came to settle in vital signs. We could extubate at dawn on the following day
without any problem.
We report this case and its management with the review of the relevant literatures.
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