周围神经刺激器用于闭孔神经阻滞麻醉下膀胱肿瘤电切术18例

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

目的观察周围神经阻滞器在闭孔神经阻滞麻醉下经尿道膀胱肿瘤电切(TURBt)术中使用的可行性和效果。方法在18例膀胱侧壁肿瘤行TURBt术前,使用周围神经刺激器定位行闭孔神经阻滞麻醉。结果17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。TURBt术中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,有效避免在TURBt术中因闭孔神经反射导致的膀胱穿孔和神经血管损伤。

Objective Observe the results and reality of the peripheral nerve stimulator in the obtu- rator nerve block in TURBt.Methods 18 cases received the peripheral nerve stimulator in obturator nerve block before TURBt.Results In 17cases obturator nerve reflection vanished;lcase had a little symptom of adductor spasm.Conclusion Obturator nerve block with the help of the nerve stimulator can increase the achievement and quality of obturator nerve block and avoid some complications caused by obturator nerve re- flection in TURBt,such as perforation of bladder and injury of nerve and vessel.