The Patient for Prostatic Surgery
The patient, a 70-year-old man, was admitted to the hospital with progressive urinary hesitancy of 2 years’ duration. Significant past medical history included hypertension and mild chronic obstructive pulmonary disease (COPD). The patient had been taking Clonidine 0.1 mg po b.i.d. and theophylline 300 mg po b.i.d. On physical examination blood pressure was 140/80 mmHg; heart rate was 68/min and regular. On auscultation the heart sounds were normal, without murmurs, gallop, or friction rub. The ECG was reported as essentially normal with nonspecific ST-T wave changes. Auscultation of the lungs revealed decreased breath sounds on both sides but no wheezing.
Laboratory values on admission showed serum sodium level 141 mEq/L, potassium 4.6 mEq/L, chloride 103 mEq/L, and total CO2 content 26 mEq/L. Fasting blood glucose level was 100 mg/dl, and creatinine 0.9 mg/dl. The hematocrit was 42%, and urine specific gravity was 1.012.
The patient was scheduled for transurethral prostatectomy (TURP). It was anticipated that the procedure would last about 90 min, and spinal anesthesia was selected.
KeywordsChronic Obstructive Pulmonary Disease Disseminate Intravascular Coagulation Regional Anesthesia Transurethral Resection Serum Sodium Level
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