COMPARISON OF HEMODYNAMIC STABILITY AND ANESTHETIC EFFICACY BETWEEN SUBARACHNOID BLOCK VERSUS SADDLE BLOCK IN PATIENTS UNDERGOING TRANSURETHRAL RESECTION OF THE PROSTATE

Abstract

Objective: To compare the efficacy and hemodynamic stability of saddle block (SA) versus conventional subarachnoid block (SAB) anesthesia in patients undergoing transurethral resection of the prostate (TURP).

Study Design: A prospective, randomized, comparative study.

Place of Study: Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan

Methodology: Two equal groups of 70 male patients undergoing elective TURP (n = 35 each) were randomly assigned. Group Saddle underwent a saddle block with 0.5% hyperbaric bupivacaine, whereas Group SAB received standard spinal anesthesia. Postoperative results, sensory and motor block features, and intraoperative hemodynamic parameters were all noted and contrasted. SPSS version 26 was used for statistical analysis. p≤ 0.05 was considered significant.

Results: Baseline characteristics were comparable between groups (p > 0.05). Saddle block maintained higher intraoperative systolic and diastolic blood pressures (p = 0.000) and lower heart rates (p = 0.012*). Hypotension (p = 0.009) and vasopressor requirements were significantly lower in the saddle group. Although sensory block onset was faster in saddle anesthesia (p = 0.001*), motor block and analgesia duration were longer in SAB (p < 0.01*). Intraoperative adverse events were fewer with saddle anesthesia (p = 0.041*).

Conclusion: Saddle block anesthesia provides adequate surgical anesthesia for TURP with superior hemodynamic stability, fewer adverse events, and faster recovery compared to conventional spinal anesthesia. It represents a safer and more controlled alternative for elderly or high-risk patients.