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Background and Aims Spinal anaesthesia is a widely used technique for transurethral resection of the prostate (TURP). Nonetheless, a critical complication associated with spinal anaesthesia is hypotension. Saddle block, an alternative technique, is a potential solution to this problem. We performed a meta-analysis to compare spinal anaesthesia’s safety with the saddle block for TURP.

Methods PubMed, EMBASE, Scopus, and Cochrane were searched for randomized controlled trials (RCTs) comparing the spinal anaesthesia to the saddle block for TURP. Outcomes assessed included haemodynamic changes, and vasopressor consumption. Statistical analyses were performed using RevMan 5.4. The risk of bias was appraised using the RoB-2 tool. Our study is registered in the PROSPERO under protocol number CRD42023417092.

Results Saddle block anaesthesia resulted in a significantly lower decrease in systolic blood pressure (Mean Difference -13.25mmHg; 95% CI -18.01 to -8.48mmHg; p<0.0001; I2 = 98%; 5RCTs; 380 patients; figure 1) and lower vasopressor needs (Risk Ratio 0.16; 95% CI 0.03 to 0.73; p 0.02; I2 = 61%; 4 RCTs; 280 patients; figure 2) when compared to spinal anaesthesia.

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Abstract OP024 Figure 1

There was a lower decrease in systolic blood pressure with saddle block than with spinal anaesthesia

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Abstract OP024 Figure 2

The use of vasopressors favoured the saddle block group

Conclusions According to our research, using saddle block anaesthesia as an alternative to spinal anaesthesia for TURP could potentially offer a more favorable haemodynamic profile and lower vasopressor consumption.