Subarachnoid block versus saddle block in patients undergoing transurethral thulium laser prostatic Ablation: A comparative study

Background: Subarachnoid block is the preferred anaesthetic technique for transurethral resection of prostate (TURP). As both spinal as well as saddle block can be used for the surgery, we aim to compare the haemodynamic parameters and adequacy of surgical condition resulting from subarachnoid block versus saddle block in patients posted for transurethral thulium laser prostatic ablation. Material and Methods: Sixty patients in the age group of 50 to 75 years, belonging to American Society of Anesthesiologists (ASA) grade I - II, posted for transurethral thulium laser prostatic ablation were included in this prospective, randomised study. Patients randomly divided into one of the two groups: Group A (n=30) - received spinal block and Group B (n=30) - received saddle block; with 2ml of 0.5% hyperbaric bupivacaine. Maximum block height was recorded. Haemodynamic parameters including heart rate (HR), oxygen saturation (SpO2), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) were monitored till the end of surgery. Incidence of complications like hypotension, volume overload, TURP syndrome etc. if encountered were noted. Results: Adequate surgical condition was achieved in both groups. Incidence of hypotension and vasopressor requirement was significantly less in Group B than Group A (p < 0.0001). No complications were noted in both the groups. Conclusion: Saddle block achieves adequate surgical condition for transurethral thulium laser prostatectomy without significant incidence of hypotension and vasopressor requirement.