耻骨后间隙镇痛治疗前列腺电切术后膀胱痉挛

目的探讨硬膜外镇痛失败后膀胱痉挛的治疗方法。方法择期前列腺电切术后患者28例，硬膜外镇痛失败或终止，发生膀胱痉挛后，随机分为两组：Ⅰ组为治疗组，行耻骨后间隙穿刺置管，接自控镇痛泵持续镇痛；Ⅱ组为对照组，给予东莨菪碱10mg肌肉注射。结果Ⅰ组13例镇痛效果满意，1例因膀胱内出血再次手术治疗，有效率为92．86％；Ⅱ组8例疼痛缓解，4例有轻度疼痛，2例加用止痛药，有效率为75％。结论耻骨后间隙镇痛，效果良好，操作简单，全身影响小，具有一定的临床应用价值。

The treatment of retropubic space analgesia for bladder spasm after transurethral resection of prostate

Objective To explore the treatment of bladder spasm after the failure of epidural analgesia. Methods Twenty-eight patients were randomly divided into two groups who experienced the failure or the end of epidural analgesia and then bladder spasm happened after selective operations of transurethral resection of prostate. Group I （treatment group） were treated with continuous patient-controlled epidural analgesia pump by puncturing retropubic space and placing a catheter when Bladder Spasm happened. Group II （control group） were treated with intramuscular injection scopolamine. Results Group I ： 13 cases obtained exact and satisfactory analgesic effect, 1 case underwent operation once again because of bladder internal bleeding, and the effective rate was 92.86%. Group II ： 8 cases pain relief, 4 cases mild pain, 2 cases used pain reliever, and the effective rate was 75%. Conclusion The method of retropubic space analgesia has good effect and is easy to operate, and the systemic effects are small, so it has certain clinical application value.