In men undergoing prostate surgery, excessive fluid absorption can lead to dangerously low sodium levels. Adding a small amount of glucose to the irrigation fluid used during surgery can help anesthesiologists prevent this complication, reports a study in Anesthesia & Analgesia.The new technique provides an effective solution to the challenge of how to monitor fluid status during transurethral resection of the prostate (TURP). The study was performed by Robert G. Hahn, MD, and colleagues of Karolinska Institutet, Stockholm.
In recent years, surgeons performing TURP have switched to an irrigation fluid containing normal saline, which can be absorbed in large amounts without dangerous effects on the blood sodium level. However, typically surgeons cannot tell that large amounts of fluid are being absorbed during prostate surgery and rely on the anesthesiologist to monitor the patient's status.
Hahn and colleagues developed a new approach where small amounts of glucose (1 percent) are added to the irrigation fluid. In the new study, They monitored changes in glucose and sodium levels in 250 patients who received the solution for irrigation during TURP. The results showed that an increase in glucose level was just as good an indicator of the patient's fluid status as a decrease in sodium level.
An additional study was performed in 10 healthy volunteers who received about 1.5 liters of a solution with a small amount of additional glucose added. Using sophisticated models of body fluid, Hahn and his team were able to show that the change in glucose levels was a reliable indicator of the amount of extra fluid in the patient's blood vessels.
“What this means for the patient is that, regardless of the fluid that the surgeon uses during prostate surgery, the anesthesiologist can simply measure the glucose level to monitor the amount of fluid absorbed,” explains Shafer.