老年患者前列腺电切术的麻醉处理

Anesthesia management of transurethral resection of prostate in elderly patients

目的：总结158例老年前列腺电切术麻醉处理的临床经验。方法：158例老年前列腺疾病患者,年龄65~86岁,硬膜外穿刺选择L3~L4椎间隙,严格控制平面在T9以下,手术中连续监测SBP、DBP、MAP、HR、SpO2和ECG。结果：所有患者硬膜外麻醉效果满意,麻醉后血压下降超过基础血压30%以上者20例。手术中发生TURP综合征4例（2.5%）全部患者手术后顺利恢复。结论：连续硬膜外阻滞麻醉是实施老年TURP的首选麻醉方法。严密监测生命体征变化,适当地使用利尿药物可有效预防水中毒的发生。

Objective：To summarize the clinical experience of anesthesia in 158 elderly cases of transurethral resection of prostate（TURP）.Methods：158 cases of prostatic diseases aged 65-86 years old,epidural puncture was located at L3~L4 intervertebral space and the level of epidural blockade was strictly controlled under T9.SBP,DBP,MAP,HR,SpO2 and ECG were continuously monitored during operation.Results：The anesthetic effect in all the patients were satisfactory.The decrement of BP in 20 cases surpassed the basic BP by more than 30%.TURP syndrome occurred in 4 cases（2.5%） during operation.All the patients recovered smoothly after operation.Conclusion：Continuous epidural anesthesia is the best choice in elderly TURP.Close observation of vital signs change and appropriate diuretics use are effective to prevent water intoxication.