经尿道输尿管镜下气压弹道碎石术的麻醉

Anesthesia in Pneumatic Lithotripsy Under Ureteroscope

目的观察腰硬联合麻醉及连续硬膜外麻醉在输尿管镜下气压弹道碎石术中的麻醉效果对比。方法将60例患者随机分为腰硬联合麻醉组(CSEA组,n=30)和连续硬膜外麻醉组(CEA组,n=30)。记录ECG、MAP、SpO2,观察麻醉平面固定时间、麻醉维持时间、肌松效果、低血压和术后头痛发生率。结果两组患者血流动力学稳定,无显著性差异(P>0.05);CSEA组麻醉平面固定时间短,维持时间长,肌松效果好,且用药量少(P<0.01),与CEA组相比差异具有显著性(P<0.05),CSEA组术后无明显头痛发生。结论腰麻硬膜外联合麻醉麻醉方式有起效快、效果确切、副作用小的优点,是尿道输尿管镜下碎石手术较好的麻醉方法之一。

Objective To compare the anaesthetic effects of CSEA （combined spinal epidural anesthesia） and CEA （continuous epidural anesthesia） in pneumatic lithotripsy under ureteroscope. Method 60 patients were randomly divided into the CSEA group and CEA group with 30 patients in each, recording ECG, MAP, SpO2, observing the fixed time of level of anesthesia, the duration of anesthesia, the effect oftetrandrine dimethiodide, the hypotension and the incidence rate of post-surgery headache. Results The hemodynamics of both groups was stable with no notable difference （P〉0.05）; the CSEA group had shorter fixed time of level of anesthesia, longer duration, better effect oftetrandrine dimethiodide and less dose（P〈0.01）, significant difference from the CEA group （P〈0.05）; no obvious post-surgery headache in CSEA group. Conclusion CSEA is a good anaesthetic method in pneumatic lithotripsy under ureteroscope, with merits of fast and precise effect and little side-effect.