超声引导下闭孔神经阻滞在经尿道膀胱肿瘤电切术中预防闭孔神经反射的效果

目的通过对比不同麻醉方式下闭孔神经反射的发生情况,探讨经尿道膀胱肿瘤电切术中预防闭孔神经反射的有效方式。方法选取需行经尿道膀胱肿瘤电切术的膀胱侧壁肿瘤患者160例,男134例,女26例,ASAⅠ~Ⅲ级,随机分为四组:全凭静脉麻醉组(G组),腰-硬联合麻醉组(C组),腰-硬联合麻醉复合静脉麻醉组(V组),腰-硬联合麻醉复合闭孔神经阻滞(obturator nerve block,ONB)组(O组),每组40例。记录不同麻醉方式下闭孔神经反射的发生情况。结果O组闭孔神经反射发生率(7.5%)明显低于C组(32.5%,P=0.005)和V组(40.0%,P=0.001),与G组闭孔神经反射发生率(5.0%)差异无统计学意义(P=0.644)。结论腰-硬联合麻醉复合闭孔神经阻滞与全凭静脉麻醉均可有效预防闭孔神经反射的发生。

Effect of ultrasound-guided obturator nerve block in prevention of obturator nerve reflex in transurethral resection of bladder tumor

Objective Comparing obturator nerve reflex in different anesthesia, to investigate the incidence of obturator nerve reflex in transurethral resection of bladder tumor. Methods A total of 160 patients with lateral wall of bladder tumors were included, who required a TURBT, were randomly divided into four groups: general anesthesia group (group G), combined spinal epidural anesthesia group (group C), combined spinal-epidural anesthesia compounding intravenous anesthesia group (group V), combined spinal-epidural anesthesia compounding obturator nerve block group (group O), n=40 in each group. The incidence of obturator nerve reflex was recorded. Results Incidence of obturator nerve reflex in group O (7.5%) was lower than in group C (32.5%, P=0.005) and group V (40.0%, P=0.001). There was no significant difference between group G (5.0%) and group O (P=0.644). Conclusion Both combined spinal-epidural anesthesia with obturator nerve block and general anesthesia can effectively prevent obturator nerve reflex.