膀胱肿瘤电切术中应用周围神经刺激器监测下行闭孔神经阻滞的体会

目的：观察周围神经阻滞器在闭孔神经阻滞麻醉下膀胱肿瘤电切术中使用的可行性和临床效果。方法：15例在骶丛麻醉下行经尿道膀胱肿瘤电切术（TURBt），术中出现闭孔神经反射时，加用周围神经刺激器在监测下行闭孔神经阻滞麻醉。结果：14例闭孔神经反射消失，1例仍有轻微的内收肌痉挛。加用副闭孔神经阻滞麻醉后，肌肉痉挛消失，继续行TURBt，再无一例发生闭孔神经反射。结论：利用神经刺激器辅助定位行闭孔神经阻滞，可以提高闭孔神经阻滞的成功率和质量，有效地避免在TURBt中因闭孔神经反射导致的膀胱穿孔和神经血管损伤。

Clinical application of the peripheral stimulation in the obturator nerve block used in the TURBt

Objective:Observe the results and reality of the peripheral nerve stimulator in the obturator nerve block in TURBt.Methods:15 cases with obturator nerve reflection in TURBt receive the peripheral nerve stimulator in obturator nerve block.Results:In 14 cases obturator nerve reflection vanish;1 cases has a little symptom of adductor spasm.Conclusions:We carry out obturator nerve block with the help of the nerve stimulator,which can increase the achievement and quality of obturator nerve block,and can also avoid complication caused by obturator nerve reflection in TURBt,Such as perforation of bladder and injury of nerve and vessel.