Spinal vs. General Anesthesia

Paper Summary:

This paper explains that the majority of research indicates that anesthetic choice has little impact on the outcome of surgery for patients undergoing TURP and related procedures. The author points out that physicians should instead take into consideration the likelihood for increased overall morbidity and mortality rates in patients due to the nature of the surgery and increased likelihood that patients are coming into a procedure with increased complications prior to surgery. The paper states that general and spinal anesthesia both carry risks, and both carry adverse side effects; which side effects a patient is best equipped to handle should be the determining factor for the majority of patients undergoing TURP.

Table of Contents
Introduction
Literature Review
Implications to Practice

From the Paper:

"There is research indicating that adverse effects may result from anesthetic choice during prostatectomy, or at least evidence indicating that in general this procedure is more risky and likely to result in a greater likelihood for poor outcome. The Department of Urology at Freeman Hospital in Newcastle, UK conducted a study that examined complications and morbidity resulting from prostatectomy in 1400 men. The patients were examined for a period of 8 months, with patients undergoing TURP examined from 12 separate institutions. Data was collected related to "factors potentially affecting mortality and morbidity" which included the American Society of Anesthesiologists co-
morbidity scores. Complications post-surgery included 8% of patients developing sepsis, with a large percentage of patients having a "significantly increased rate of deaths and complications" and emergent situations requiring re-admission to the hospital . The study concluded that due to the increased likelihood of complications, which were seen across population groups of varying ages, it is essential that care providers further examine potential increased causes for morbidity rates after prostatectomy. The increased likelihood of complications was not directly tied to anesthetic technique, but this possibility was also not ruled out."

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