A 70 year old patient with benign prostatic hyperplasia underwent transuretheral resection of prostate under spinal anaesthesia. One hour later, he developed vomiting and altered sensorium. The most probable cause is ?
**Core Concept**
The question tests the understanding of potential complications following transurethral resection of the prostate (TURP), particularly under spinal anesthesia. **TURP syndrome** is a key consideration in such scenarios, involving fluid overload and hyponatremia due to absorption of irrigating fluid.
**Why the Correct Answer is Right**
The correct answer is related to TURP syndrome, which occurs due to excessive absorption of the irrigating fluid used during the procedure. This fluid, often a hypotonic solution, can lead to **dilutional hyponatremia**, causing neurological symptoms such as altered sensorium and potentially vomiting.
**Why Each Wrong Option is Incorrect**
**Option A:** This choice is not directly related to the common complications of TURP or spinal anesthesia that would cause the described symptoms.
**Option B:** Similarly, this option does not align with the typical post-procedure complications that would result in vomiting and altered sensorium.
**Option C:** This choice is also incorrect as it does not directly relate to the absorption of irrigating fluid or the effects of spinal anesthesia.
**Clinical Pearl / High-Yield Fact**
A crucial point to remember is that TURP syndrome can be prevented or managed by monitoring the patient's fluid status and serum sodium levels closely during and after the procedure. Early recognition of symptoms such as nausea, vomiting, and altered mental status is critical.
**Correct Answer:** D. TURP syndrome.