骶管阻滞麻醉在选择性绿激光前列腺切除术的应用

Experience with sacral block regional anesthesia for greenlight photoselective vaporization of prostate

目的：探讨经尿道选择性绿激光前列腺切除术治疗高危高龄前列腺增生症的简单可行麻醉方法。方法：56例高危高龄前列腺增生症患者，应用2％利多卡因单次骶管阻滞麻醉，施行选择性绿激光前列腺切除术（PVP），采用疼痛分级问卷调查表及根据术中情况判断麻醉效果。结果：除1例患者术中改为硬膜外麻醉外，55例患者在骶管麻醉下成功施行手术，麻醉止痛作用起效时间：5min22例；10min29例；15min4侧。麻醉持续时间：60min38例；60～180min17例。疼痛抑制效果满意，麻醉满意评分为：0度48例；Ⅰ度5例；Ⅱ度2例。其中4例出现轻微的头晕、心慌、耳鸣等症状，其余未见明显麻醉并发症。结论：单次骶管阻滞麻醉是施行PVP的一种简单、安全和有效的麻醉方法，费用低，使PVP可在门诊完成。

Objective：To explore the effect of appropriate local anesthesia in the greenlight photoselective vaporization of prostate （PVP） on the high-risk patients with benign prostatic hyperplasia （BPH）. Methods：A total of 56 high-risk patients with BPH were examined in this study. We carried out PVP in 55 of them under sacral block regional anesthesia with lignocaine chloride. Patient discomfort level during each block was assessed using pain grade questionnaire. Results：We had perfect pain control in the majority of the patients except that one patient required conversion to epidural anesthesia. Patients＇acceptance was very high. The anesthetic beginning effect time was 5min of 22 patients, 10min of 29 patients and 15min of 4 patients, respectively. The anesthetic duration time was 60 min of 38 patients and 60-180 min of 17 patients. The anesthesia satisfactory with pain grade 0, I and II was 48 patients, 5 patients and 2 patients, respectively. Only four patients had sligh dizzy, panicky and tinnitus, no other complication of the anesthetic procedure occurred. Conclusion：It is concluded that caudal anesthesia with 2% lignocaine chloride gives adequate anesthesia for greenlight photoselective vaporization resection of the prostate gland. We believe that ours is a simple, safe and effective procedure.