A 68-year-old man undergoes transurethral resection of the prostate under spinal anaesthesia. Two hours into the procedure, he becomes confused, bradycardic, and hypotensive. Serum sodium is 118 mEq/L. Which irrigating solution is MOST likely responsible for this clinical picture?
- A Normal saline (0.9% NaCl)
- B Lactated Ringer's solution
- C Glycine 1.5% ✓
- D Dextrose 5% in water
Correct answer: C. Glycine 1.5%
Explanation
TURP syndrome results from systemic absorption of hypotonic irrigating fluid through open prostatic venous sinuses. Glycine 1.5% is the most commonly used irrigant and is hypotonic, causing acute hyponatremia, hypervolemia, and hyperglycinemia. Normal saline and Lactated Ringer's are isotonic and would not produce hyponatremia.
Reference: Miller's Anesthesia, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.