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Spinal Versus General Anesthesia on Coagulation and Fibrinolysis During Transurethral Resection of the Prostate
Effects of Spinal Versus General Anesthesia on Coagulation and Fibrinolysis in Patients Undergoing Transurethral Resection of the Prostate: A Prospective Randomized Study
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
Transurethral resection of the prostate (TURP) is one of the most commonly performed surgical procedures for benign prostatic hyperplasia. Surgical trauma activates both coagulation and fibrinolytic pathways, and prostate tissue possesses unique fibrinolytic properties due to its high concentration of plasminogen activators. The anesthetic technique may modify perioperative hemostasis through its effects on the neuroendocrine stress response.
The purpose of this prospective randomized study is to compare spinal anesthesia and general anesthesia with respect to perioperative and early postoperative changes in coagulation and fibrinolysis. Venous blood samples are obtained before surgery and at 1 and 24 hours after surgery for measurement of prothrombin time, activated partial thromboplastin time, international normalized ratio, fibrinogen concentration, and D-dimer levels.
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Istanbul
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Istanbul, Istanbul, Turkije (Türkiye), 34265
- Sultangazi Haseki Training and Research Hospital
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Male patients
- Age ≥18 years
- Scheduled for elective bipolar transurethral resection of the prostate
- ASA physical status I-II
- Ability to provide written informed consent
Exclusion Criteria:
- History of deep vein thrombosis or pulmonary embolism
- Known inherited or acquired coagulation disorder
- Severe hepatic insufficiency
- Severe renal insufficiency
- Use of anticoagulants, antiplatelet drugs, or NSAIDs within 10 days before surgery
- Platelet count <100 × 10⁹/L
- INR >1.5
- aPTT >47 seconds
- Contraindications to spinal anesthesia
- Prostate malignancy
- ASA physical status III or higher
- Refusal to participate
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: spinal anesthesia
Participants received spinal anesthesia with hyperbaric bupivacaine for elective bipolar transurethral resection of the prostate (TURP).
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Spinal anesthesia was performed at the L4-L5 interspace using 12.5 mg of hyperbaric bupivacaine for elective bipolar transurethral resection of the prostate (TURP).
Standard intraoperative monitoring and perioperative management were applied.
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Actieve vergelijker: general anesthesia
Participants received standardized general anesthesia for elective bipolar transurethral resection of the prostate (TURP).
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General anesthesia was induced with intravenous propofol, fentanyl, and rocuronium, and maintained with sevoflurane.
Standard intraoperative monitoring and perioperative management were applied during elective bipolar transurethral resection of the prostate (TURP).
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change in Prothrombin Time (PT) from Baseline to Postoperative Assessments
Tijdsspanne: Baseline, 1 hour after surgery, and 24 hours after surgery
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Prothrombin time (PT) will be measured to evaluate perioperative changes in the extrinsic coagulation pathway.
Unit of Measure: Seconds
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Baseline, 1 hour after surgery, and 24 hours after surgery
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Change in Activated Partial Thromboplastin Time (aPTT) from Baseline to Postoperative Assessments
Tijdsspanne: Baseline, 1 hour after surgery, and 24 hours after surgery
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Activated partial thromboplastin time (aPTT) will be measured to evaluate changes in the intrinsic coagulation pathway.
Units of measure: seconds
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Baseline, 1 hour after surgery, and 24 hours after surgery
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Change in International Normalized Ratio (INR) from Baseline to Postoperative Assessments
Tijdsspanne: Baseline, 1 hour after surgery, and 24 hours after surgery
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INR will be measured as a standardized indicator of coagulation status.
Unit of Measure: Ratio
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Baseline, 1 hour after surgery, and 24 hours after surgery
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Change in Fibrinogen Concentration from Baseline to Postoperative Assessments
Tijdsspanne: Baseline, 1 hour after surgery, and 24 hours after surgery
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Plasma fibrinogen concentration will be measured to evaluate changes in coagulation activity.
Unit of Measure: mg/dL
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Baseline, 1 hour after surgery, and 24 hours after surgery
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Change in D-dimer Concentration from Baseline to Postoperative Assessments
Tijdsspanne: Baseline, 1 hour after surgery, and 24 hours after surgery
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Plasma D-dimer concentration will be measured to evaluate perioperative fibrinolytic activation.
Unit of Measure: mg/L
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Baseline, 1 hour after surgery, and 24 hours after surgery
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Incidence of adverse events
Tijdsspanne: From induction of anesthesia until completion of surgery.
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From induction of anesthesia until completion of surgery.
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Medewerkers en onderzoekers
Publicaties en nuttige links
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Urogenitale ziekten
- Genitale ziekten
- Vaatziekten
- Hart-en vaatziekten
- Genitale ziekten, man
- Prostaat Ziekten
- Mannelijke urogenitale ziekten
- Embolie en trombose
- Trombose
- Prostaathyperplasie
- Organische chemicaliën
- Anilides
- Amides
- Aniline -verbindingen
- Amines
- Anesthesie en analgesie
- Anesthesie, geleiding
- Anesthesie
- Bupivacaïne
- Anesthesie, wervelkolom
- Anesthesie, algemeen
Andere studie-ID-nummers
- 18-2024
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Beschrijving IPD-plan
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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