腰硬联合麻醉与单纯硬膜外麻醉在TURP手术中效果的比较

Efficacy Comparison of Combined Spinal-Epidural Anesthesia and Continuous Epidural Anesthesia in Patients Undergoing TURP

目的比较腰硬联合麻醉和连续硬膜外麻醉对经尿道前列腺电切术患者麻醉效果及呼吸循环功能的影响,探讨经尿道前列腺电切术恰当的麻醉方法。方法将60例经尿道前列腺电切术患者随机分成两组:连续硬膜外麻醉(CEA);腰硬联合麻醉(CSEA);每组30例。观察麻醉前、麻醉注药后5、10、15、30min时心率、血压、呼吸次数和氧饱和度及麻醉起效时间、阻滞完善时间、最高感觉阻滞平面,并评价麻醉效果。结果CSEA组和CEA组最高感觉阻滞平面均未超过T6,对呼吸频率和潮气量无明显影响,SpO2>97%;两组患者术中BP、HR变化无统计学差异。麻醉起效时间、到达最高阻滞平面的时间CSEA组均小于CEA组。比较两组麻醉完善率,CSEA组优于CEA组,有明显差异(P<0.05)。结论腰硬联合麻醉和连续硬膜外麻醉均可安全有效的用于经尿道前列腺电切术患者,麻醉效果CSEA组明显优于CEA组。

Objective To compare the effect of respiratory system and circulatory function and anesthetic efficacay for CSEA and CEA in patients undergoning TURP , discussion the appropriate anesthesia for TURP. Methods Sixty patients undergoing TURP were randomly divided into CEA group （ n = 30 ） and CSEA group（n = 30）. Monitoring before anesthesia, anesthesia injection after 5min, 10min, 15min, 30min at the time of BP, HR, RR, SpO2, the onset time of pain free, duration time, and block height were recorded, and to evaluate the quality of intraoperative anesthesia. Results The highest of sensory block in 2 groups did not exceed the T6, the respiratory frequency and tidal volume had no significant effect, SpO2 〉 97%. There was no marked difference in BP, HR between the 2 groups. The onset time of block and the time to reach the height level in CSEA group were less than that in CEA group, 2 groups of patients withehange was no significant difference. Compared between the 2 groups to improve the rate of saisfactory block, CSEA group was better than CEA group, have significant differences （ P 〈 0.05 ）. Conclusion CSEA and CEA are safe and effective for TURP patients ,but CSEA group was significantly better than CEA group.