Preoperative comorbidities and relationship of comorbidities with postoperative complications in patients undergoing transurethral prostate resection.

PURPOSE: We retrospectively identified preoperative comorbidities and analyzed the relationship of the comorbidities to postoperative complications in patients treated with transurethral prostate resection. MATERIALS AND METHODS: We reviewed the surgical and clinical records of 1,878 patients who underwent transurethral prostate resection at a single university hospital between January 2006 and December 2009. Variables included preoperative comorbidities, intraoperative data and postoperative complications, including mortality. RESULTS: Only 32.6% of the patients had no observed preoperative comorbidity and the other 67.4% had at least 1. The incidence of comorbidities increased with age (p <0.001). The overall postoperative complication rate was 5.8%. There were 3 deaths for an overall 0.16% 30-day mortality rate. The postoperative complication rate was significantly higher in patients who had a comorbidity preoperatively and were 50 to 59 (p = 0.043), 60 to 69 (p = 0.028) and 70 to 79 years old (p = 0.017). The Charlson comorbidity index was significantly associated with postoperative complications (r(2) = 0.221, p = 0.012). CONCLUSIONS: Almost two-thirds of the patients who underwent transurethral prostate resection had various preoperative comorbidities. The fact that the preoperative comorbidity was significantly related to postoperative complications after transurethral prostate resection should be considered in perioperative management in this population.

Changes of dorsalis pedis artery flow pattern after caudal block in children: observational study using a duplex sonography.

OBJECTIVE: To evaluate the changes of the flow velocity, the volume flow, and the diameter of dorsalis pedis artery using a duplex ultrasonography after caudal block with sevoflurane anesthesia in children. AIM: To know the acute change in peripheral arterial flow patterns of sympathetically blocked lower limbs in anesthetized children. BACKGROUND: Caudal analgesia in combination with general anesthesia may affect the circulatory hemodynamics due to sympatholytic vasodilating effects. METHODS: After approval by the Ethics Committee, we evaluated the changes of peripheral hemodynamics using a duplex ultrasonography before and after a caudal block in sevoflurane-anesthetized children. RESULTS: A caudal block using 0.15% ropivacaine 1.5 ml·kg(-1) significantly altered the arterial flow patterns; increased peak velocity (24%) and volume flow (76%), and the diameter of the dorsalis pedis artery (20%) in children. However, blood pressures and heart rates were not affected significantly by caudal block. CONCLUSIONS: Duplex sonographic measurements indicate that a caudal block changes the flow patterns of the dorsalis pedis artery significantly in the anesthetized children.