A Randomized Study of the Efficacy of Low Venous Pressure General Anesthesia Versus Combined Spinal-Epidural Anesthesia in Decreasing Blood Loss During Prostate Surgery

Inclusion Criteria: * They are scheduled for RRP by Drs. Scardino or Eastham. * They speak English in order to cooperate during CSE if randomized to such arm. * They have clinically localized disease, clinical stage \< cT3NxM0 (1997 TNM), any Gleason grade * Must be willing to receive blood products or blood if deemed clinically necessary * Must be willing to receive epidural or general anesthesia * All subjects must be age 18 or older * Patient or the patient's legally acceptable representative must sign and date informed consent PRIOR to any study related procedures being performed. * Patient must have an MRI of the prostate done at MSKCC prior to RRP. Exclusion Criteria: * Prior history of significant cardiac disease (defined as unstable angina, coronary artery stent placement within 8 weeks of surgery, MI within 6 months of surgery, known history of cardiomyopathy, congestive heart failure or significant valvular heart disease), insulin dependent diabetes mellitus, or clinically significant carotid artery disease. * Presence of renal insufficiency (define by creatinine level \> 1.6 mg/dl). * Prior radiation therapy to the pelvis or prostate * History of bleeding tendencies, hemorrhagic diathesis, or known primary or secondary hematological disease such as chronic renal failure, Von Willebrand disease, and thrombocytopenia among others. * History of lumbar spine disease or peripheral neurological conditions that may contraindicate use of CSE anesthesia. * Prior transure…