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Anesthesia for Urological Procedures

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Abstract

Urologic procedures represent a substantial number of surgical cases occurring in both ambulatory surgery centers and inpatient hospitals. A considerable number of urologic surgery patients are elderly and suffer a wide range of comorbidities that require preoperative evaluation and medical optimization. Urologic procedures can be divided into endoscopy (endourologic) and major abdominal surgery. Endourologic procedures represent a sizeable volume of urologic surgery and can generally be performed on an outpatient basis. Common endourologic procedures include cystoscopy for treatment of prostatic enlargement/obstruction or bladder tumors and ureteroscopy for treatment of bladder stones. A wide variety of anesthetic techniques may be used, including monitored anesthesia care (MAC), neuraxial and general anesthesia.

Major urologic procedures include radical prostatectomy, radical or partial nephrectomy, and radical cystectomy. A discussion of the anesthetic concerns related to these procedures includes preoperative evaluation, patient positioning, anesthetic techniques and postoperative pain control. Nephrectomy and cystectomy both carry a substantial risk of blood loss and as a result may require invasive monitors and immediate availability of blood products. Enhanced Recovery After Surgery (ERAS) protocols have widely been accepted in major urologic procedures; elements often included or adapted as part of these urologic care algorithms will additionally be discussed in this chapter

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Authors and Affiliations

  1. Department of Anesthesiology, Oschner Medical Center, New Orleans, LA, USA

    Hussam Ghabra M.D. & Susan A. Smith M.D.

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  1. Hussam Ghabra M.D.
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  2. Susan A. Smith M.D.
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Correspondence to Susan A. Smith M.D. .

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Editors and Affiliations

  1. Hospital University Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA

    Basavana G. Goudra

  2. Department of Anesthesiology, Emory University, Atlanta, Georgia, USA

    Michael Duggan

  3. Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA

    Vidya Chidambaran

  4. University Hospitals Birmingham, Birmingham, United Kingdom

    Hari Prasad Krovvidi Venkata

  5. Emory University Hospital, Atlanta, Georgia, USA

    Elizabeth Duggan

  6. University of Alabama at Birmingham, Birmingham, Alabama, USA

    Mark Powell

  7. All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India

    Preet Mohinder Singh

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Ghabra, H., Smith, S.A. (2018). Anesthesia for Urological Procedures. In: Goudra, B., et al. Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-74766-8_76

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