腰麻-硬膜外联合麻醉在经尿道前列腺电切术中的应用

目的 探讨腰麻-硬膜外联合麻醉(CSEA)、单纯硬膜外麻醉(EA)在经尿道前列腺电切术(TURP)中的临床效果和安全性.方法 择期行TURP的患者120例,随机分成CSEA组和EA组,每组60例采用.麻醉过程中监测循环及呼吸相关参数,观察麻醉效果、并发症及不良反应.结果 2组麻醉效果均满意,对血流动力学影响轻微,麻醉前、手术开始及结束时收缩压(SBP)、舒张压(DBP)、心率(HR)的变化在组内和组间比较无显著性差异(P＞0.05);2组均无术中恶心呕吐、术后头痛等不良反应发生.EA组有5例发生闭孔神经反射,CSEA组无一例发生(P＜0.01).结论 CSEA、EA应用于TURP均能取得安全满意的麻醉效果,CSEA能更好地防止闭孔反射的发生,更能满足TURP的要求.

Clinic investigation of combined spinal-epidural anesthesia in TURP

Objective To investigate and compare the clinical efficacy and safety of the two anesthesiological approaches applied in TURP. Methods 120 cases scheduled to undergo TIRP were randomly assigned to two groups: sixty cases underwent CESA, while the other sixty cases underwent EA. Parameters concerning circulation and respiration were monitored to observe anesthesia efficacy, complications and adverse reactions. Results There were no difference between the two groups in the hemodynamic changes, with satisfactory anesthesia effects. No significant differences in SBP, DBP and HR were observed in preanesthesia, at the beginning and the end of operation within and between each group (P>0.05). No nausea and vomiting during operation or postoperative headache occurred. 5 cases in EA group had obturator nerve reflex, while none occurred in CSEA group (P<0.01). Conclusion Both CSEA and EA were applied in TURP with satisfactory and safe effects in anesthesia, whereas CSEA could better prevent the occurrence of obturator nerve reflex and better meet the requirement of TURP.