TURP syndrome

SummaryA 70 year old man with underlying cardiac disease presented for elective transurethral prostate resection. General anaesthesia was administered uneventfully until the patient presented with an asystolic cardiac arrest only 33 min into the procedure. The patient was resuscitated and the cardiac output restored after 7 min of cardiopulmonary resuscitation. Subsequent tests revealed a serum sodium of 102 mmol/litre and transurethral resection of the prostate syndrome as cause for the arrest. This unusual but dangerous complication presenting during transurethral resection of the prostate illustrates how regional anaesthesia, better communication and earlier use of the alcometer can lead to earlier diagnosis and better management of this complication. The use of normal saline as irrigation fluid, with bipolar diathermy may signal the end of the life threatening complications associated with glycine and hyponatraemia.