The utility of intravenous ketamine for the management of intraoperative penile erection: a retrospective single-center analysis of endourological surgeries over a 4-year.

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Tytuł:: The utility of intravenous ketamine for the management of intraoperative penile erection: a retrospective single-center analysis of endourological surgeries over a 4-year.
Autorzy:: Eroğlu A; Department of Urology, Başkent University Research and Training Medical Center, Izmir, Turkey. .
Tuncalı B; Department of Anesthesia and Reanimation, Başkent University Research and Training Medical Center, Izmir, Turkey.
Ekin RG; Department of Urology, Urla State Hospital, Izmir, Turkey.
Źródło:: BMC urology [BMC Urol] 2020 Jan 28; Vol. 20 (1), pp. 4. Date of Electronic Publication: 2020 Jan 28.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: London : BioMed Central, [2001-
MeSH Terms:: Analgesics/*administration & dosage
Endoscopy/*methods
Intraoperative Complications/*prevention & control
Ketamine/*administration & dosage
Penile Erection/*drug effects
Administration, Intravenous ; Aged ; Endoscopy/adverse effects ; Humans ; Intraoperative Complications/physiopathology ; Male ; Middle Aged ; Penile Erection/physiology ; Retrospective Studies
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Contributed Indexing:: Keywords: Intraoperative penile erection ∙ ketamine ∙ endourology ∙ treatment outcome
Substance Nomenclature:: 0 (Analgesics)
690G0D6V8H (Ketamine)
Entry Date(s):: Date Created: 20200130 Date Completed: 20201118 Latest Revision: 20201118
Update Code:: 20240105
PubMed Central ID:: PMC6985998
DOI:: 10.1186/s12894-020-0574-1
PMID:: 31992278
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Background: To assess the prevalence of intraoperative penile erection in our endourology practice and the utility of intravenous ketamine in the management of the condition.
Methods: Of 402 endoscopic urological procedures performed in our clinic over a 4-year (2015-2019) period, a total of 9 cases with intraoperative penile erection impeding instrumentation during endourological surgery were included. Data on patient age, weight, height, American Society of Anesthesiologists (ASA) physical status classification system scores, type and duration of surgery, type and level of anesthesia, onset of erection, treatment characteristics and treatment outcome were recorded for each patient.
Results: The mean (SD) age was 68.3 years (range, 66.0-77.0 years). ASA physical status category I and II were noted in 55.6 and 44.4% of patients, respectively. All cases received spinal anesthesia (n = 9) at T8-10 dermatome levels, for TURP in 7 (77.8%) cases and for TURBT in 2 (22.2%) cases. The onset of penile erection was post-urethroscope in 7 (77.8%) cases. The average total ketamine dose was 34.3 mg (range, 18.0-75.0 mg). The average duration of the operation was 91.7 min (range, 40.0-140.0 min). Ketamine treatment resulted in resolved erection with delayed procedure in 7 (77.8%) cases, while conversion to general anesthesia was required in 2 (22.5%) cases.
Conclusions: In conclusion, the prevalence of intraoperative penile erection during spinal anesthesia for endourological surgery was 2.2% in our experience. These findings demonstrated that intravenous injection of ketamine is an effective and safe method for immediate resolution of intraoperative penile erection with a high success rate.

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