The effect of bipolar and monopolar resectoscope use on optic nerve diameter in transurethral resection of the prostate

Abstract

Aim: The aim of this study was to investigate the effects of monopolar and bipolar\rtechniques of TURP under spinal anesthesia on serum electrolytes and changes in hemodynamic\rparameters, and to determine intracranial pressure changes by measuring optic\rnerve diameter with ultrasonography.\rMaterial and Method: Eighty ASA II-III patients who included in the study. The\rpatients were divided into two groups as the monopolar and bipolar according to the\rresectoscope technique used by the surgeon. All patients underwent surgery under spinal\ranesthesia. Optic nerve sheath diameter was measured with ultrasound and the levels\rof Na+, K+, Hb were measured before and after the operation. In addition, the mean\rarterial pressure, heart rate and peripheral oxygen saturation of the patients were recorded\rat regular time intervals, and the amount of irrigation solutions used, the amount of\rintravenous volume administered and duration of operation were recorded.\rResults: In this study including 80 patients, the MAP and heart rate of patients at all\rperioperative time points and postoperative measurements were significantly lower when\rcompared to baseline values (p < 0.001). The volume of irrigation fluid used was significantly\rhigher in group monopolar (p = 0.004), and the duration of operation was also\rsignificantly longer in group monoplar compared to group bipolar (p = 0.035). The decrease\robserved in postoperative Na+ values of group monoplar was significant compared\rto baseline value (p = 0.01). In addition, a significant difference was found between the\rgroups in terms of mean postoperative Na+ values (p < 0.001). While the change in preoperative\rand postoperative hemoglobin values in both groups was statistically significant,\rno difference was observed between the groups (p < 0.001 and p = 0.02, respectively).\rThe change in optic nerve sheath diameter was significant in both groups (p < 0.001 for\rboth).\rConclusion: In TUR-P surgery, ICP changes in patients can be followed by ONSD\rmeasurement using ultrasound.