Spinal versus epidural anesthesia for transurethral resection of the prostate

OBJECTIVE: To compare spinal versus epidural anesthesia for transurethral resection of the prostate.

METHODS: A total of 65 patients undergoing transurethral resection of the prostate between September 1996 and March 1997, from the King Hussein Medical Centre, Amman, Jordan, were enrolled in this study.

RESULTS: Epidural anesthesia was successful in 30 patients using an initial dose of 15 ml of 0.5% bupivicaine; whereas spinal anesthesia was successful in 32, using 2.5 ml of 0.5% bupivicaine. Sensory blockade at the level of T8 was similar in both techniques as were hypotension and postoperative hemorrhage. Differences occurred in the degree of motor blockade with a mean Bromage of 1 in the spinal group versus 3.8 in the epidural group (p <0.05). Maximum cephalic spread was achieved in 13 minutes in the spinal group versus 21 minutes in the epidural group (p<0.05), and the dose of propofol required to produce adequate hypnosis was 1.95 mg/kg/hour in the spinal group versus 2.8 mg/kg/hour in the epidural group (p<0.05).

CONCLUSION: Spinal anesthesia proved to be superior to epidural anesthesia by providing lower incidence of patient movement.