RESUMO
We report a case of transurethral resection of prostate (TURP) syndrome with severe hyponatremia (98 mEq x l(-1)). A relatively healthy 71-year-old man (167 cm and 61 kg) with benign prostatic hypertrophy was scheduled for transurethral resection of the prostate under general anesthesia. Ninety minutes after starting the operation, electrolyte analysis revealed a decrease in serum Na concentration (Na 98 mEq x l(-1), BE -6.4), and 7% NaHCO3 60 ml + saline 500 ml were rapidly administered, and saline 500 ml + 10% NaCl 60 ml were administered at a rate of 100 ml per hour (Na 32 mEq x hr(-1)). One hour later, serum Na concentration was 111 mEq x l(-1). No ECG changes were observed during TURP. No neurological signs were observed, postoperatively. Central pontine myelinolysis (CPM) has been associated with excessively rapid correction of chronic hyponatremia. However, the pathophysiology of chronic hyponatremia is different from that of acute hyponatremia. Central pontine myelinolysis has not yet been reported after correction of acute hyponatremia in the TURP patient. Acute hyponatremia during TURP should be corrected rapidly, because acute hyponatremia can cause neurological complications.