Evaluation of perioperative serum sodium and potassium changes in patients undergoing transurethral resection of the prostate under subarachnoid block—an observational cross-sectional study.

Ankur Sehgal; Priya Sharma; Nishu Grover; Sheetal Singla

doi:10.51168/39beeb07

Authors

Ankur Sehgal Senior Resident, Department of Anaesthesiology, Pt. B. D. Sharma PGIMS Rohtak, Haryana, India.
Priya Sharma Senior Resident, Department of Anaesthesiology, Pt. B. D. Sharma PGIMS Rohtak, Haryana, India.
Nishu Grover Senior Resident, Department of Anaesthesia, Pt. BD Sharma University of Health Sciences, Rohtak, Haryana, India
Sheetal Singla Senior Resident, Department of Anaesthesia, Pt. BD Sharma University of Health Sciences, Rohtak, Haryana, India

DOI:

https://doi.org/10.51168/39beeb07

Keywords:

Transurethral resection of prostate, Serum sodium, Serum potassium, Glycine irrigation, Electrolyte imbalance, Transurethral Resection of the Prostate syndrome

Abstract

Background:

Transurethral resection of the prostate (TURP) may cause fluid and electrolyte disturbances due to absorption of irrigation fluid. This study evaluated changes in serum sodium and potassium in relation to the duration of TURP.

Methods:

This prospective observational study included 104 patients undergoing elective TURP under subarachnoid block from August 2025 to July 2026. Patients were divided according to resection duration into Group 1 (<45 minutes; n=52) and Group 2 (>45 minutes; n=52). Serum sodium and potassium were measured preoperatively, intraoperatively at 40 minutes, and postoperatively. Operative and hemodynamic parameters were also assessed.

Results:

Patients undergoing TURP for more than 45 minutes had significantly greater irrigation-fluid use (15.8 ± 2.7 vs. 10.9 ± 2.1 L; P < 0.001) and tissue resection (45.7 ± 8.1 vs. 30.2 ± 6.4 g; P < 0.001). The postoperative serum sodium level was significantly lower in Group 2 than in Group 1 (134.8 ± 3.7 vs. 137.6 ± 3.1 mEq/L; P < 0.001), with a greater reduction from baseline (4.1 ± 1.8 vs. 1.6 ± 1.2 mEq/L; P < 0.001). Postoperative serum potassium was significantly higher in Group 2 (4.46 ± 0.38 vs. 4.28 ± 0.33 mEq/L; P = 0.011). No significant between-group differences in heart rate or mean arterial pressure were observed at the assessed time points, and no clinically evident TURP syndrome was reported.

Conclusion:

Prolonged TURP was associated with greater sodium reduction and potassium elevation, emphasizing the importance of perioperative electrolyte monitoring.

Recommendation:

Perioperative electrolyte monitoring should be considered, particularly during prolonged TURP procedures, to facilitate early detection and management of electrolyte disturbances.

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