Anesthesia for Cystectomy

Abstract

Objectives: To determine the common pre-existing medical condition, the anesthetic technique used, monitoring, complication, the duration of stay in postoperative ICU, and mortality of cystectomy.
Methods: Between February 1998 and July 1999, 61 patients underwent cystectomy for bladder carcinoma. Their medical conditions, anesthetic technique, monitoring, complication, and perioperative mortality were recorded.
Result: The common associated diseases were hypertension (18%), renal insufficiency (16.4%), and diabetes (13.1%). Combined general and epidural anesthesia was chosen in 80.3% of cases. Besides standard monitoring, 80.3% of patients had central venous pressure monitoring. Complications that occurred were hypotension, hypothermia and massive transfusion. There was one intraoperative death from massive bleeding. Postoperatively, 82.0% of patients were admitted in the ICU and the mean duration of admission in ICU was 1.1 (S.D. 0.63) days.
Conclusion: Anesthesia for cystectomy needs vigilance and combined general and regional anesthesia is the technique of choice. Because of the long operative time and invasive surgery, patients often experienced intraoperative hypotension and hypothermia. Central venous pressure monitoring was useful and commonly used. Postoperatively, most patients were admitted to the ICU but mostly for only 1 day, therefore ICU admission may not always be necessary.