Effects of Intraprostatic and Periprostatic Injections of Mepivacaine Epinephrine on Intraprostatic Blood Flow during Transurethral Microwave Thermotherapy: Correlation with [15O]H2O-PET
| Autor: | Sonny Schelin, Lennart Wagrell, Anders Claezon, Anders Sundin |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Epinephrine Urology medicine.medical_treatment Prostatic Hyperplasia Injections Intralesional Periprostatic Humans Vasoconstrictor Agents Medicine In patient Anesthetics Local Aged Patient comfort business.industry Transurethral microwave thermotherapy Prostate Transurethral Resection of Prostate Blood flow Middle Aged Drug Combinations Catheter Early results Positron-Emission Tomography Anesthesia Mepivacaine Mepivacaine+epinephrine business |
| Zdroj: | Journal of Endourology. 18:965-970 |
| ISSN: | 1557-900X 0892-7790 |
| Popis: | Background and Purpose: Experiences with the ProstaLund Feedback Treatment® (PLFT®) with the CoreTherm® device and results from a previous positron emission tomography (PET) study suggest that the intraprostatic blood flow increases considerably during treatment in response to heat exposure. Early results with intraprostatic injection of mepivacaine epinephrine prior to PLFT have indicated greater patient comfort during treatment and shorter treatment time secondary to lower intraprostatic blood flow. In this pilot study, the effect of intraprostatic injection of mepivacaine epinephrine on intraprostatic blood flow before and during PLFT was evaluated by PET using [ 1 5 O]H 2 O. Patients and Methods: In four patients scheduled for PLFT, a baseline value of the intraprostatic blood flow was established using [ 1 5 O]H 2 O-PET. Thereafter, intraprostatic injections of mepivacaine epinephrine were given using a prototype of the Schelin Catheter. In two of the patients, PET was performed immediately after the mepivacaine epinephrine injections and 10 and 24 minutes after the start of PLFT. To reduce the risk of wash-out of the drug, the next two patients were examined 7 and 17 minutes after the start of PLFT but not in connection with the anethetic injection. Results: In patients 1 and 2, mepivacaine epinephrine decreased the prostatic blood flow. During PLFT, there was a slight increase in blood flow in patient 1 and a more pronounced increase in patient 2. In patient 3, the blood flow during treatment was almost unchanged, while it decreased in patient 4. Conclusions: Intraprostatic injection of mepivacaine epinephrine may reduce, or even eliminate, the increase in blood flow that is usually seen during PLFT. The vague effect seen in patients 1 and 2 may be explained by wash-out of the drug. |
| Databáze: | OpenAIRE |
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