尿道海绵体麻醉在前尿道狭窄尿道内切开术中的应用

Optical urethrotomy for anterior urethral stricture under a new local anesthesia: intracorpus spongiosum anesthesia

目的:探讨尿道海绵体麻醉在实施前尿道狭窄尿道内切开术操作中的麻醉效果。方法:消毒后将皮试针头刺人阴茎头海绵体,缓慢注射1%～2%的利多卡因2～3ml,注入时间至少1min,拔针后纱布压迫1～3min止血。随后进行前尿道狭窄尿道内切开手术操作。根据疼痛分级标准,评估患者对疼痛的主观感觉。结果:阴茎头注射利多卡因后,立刻产生最佳麻醉止痛效果。操作时间15～45min,18例患者全部无疼痛,所有手术操作均圆满完成。手术时间最长达45min而无须任何静脉镇静剂或强化止痛处理。本组患者中无严重麻醉并发症。结论:尿道海绵体麻醉是一种效果可靠、操作简单、安全且价格低廉的局部麻醉技术,在前尿道狭窄尿道内切开术中可常规使用此局部麻醉方法。

Objectives：To determine the feasibility of routinely performing internal urethrotomy for anterior urethral stricture under intracorpus spongiosum anesthesia in an outpatient setting.Methods：In a consecutive series of 18 patients with anterior urethral stricture,a dosage of 2-3 ml of 1%-2% lidocaine was slowly injected into the glans penis. Next, optical urethrotomy was performed immediately with a cold-cutting knife. According to pain scale, the effect of this anesthetic technique was assessed by questionnaire.Results ： Internal urethrotomy was successfully completed in all the patients. All patients had no pain or discomfort. All the minor procedures varying from 15 to 45 minutes in duration were successfully completed under the new local anesthesia without any additional Ⅳ sedation.The anesthesia was very satisfactory without any complications.Conclusions ： Under intracorpus spongiosum anesthesia, optical urethrotomy can be routinely performed in an outpatient setting. With this new local anesthesia, internal urethrotomy is a safe, effective, simple, and inexpensive procedure for treatment of anterior urethral stricture.