耻骨后间隙持续镇痛在TURP术后镇痛中的应用(附50例报告)

The Application of Continous Retzius'Cavity Analgesia in Patients Undergoing TURP(Report of 50 Cases)

目的:探讨耻骨后间隙持续镇痛(continous Retziuscavity analgesia,CRA)在TURP术后镇痛中的作用机理、可行性及安全性。方法:对50例TURP患者术后采用CRA,观察术后膀胱痉挛主观症状(VAS)评分、膀胱持续冲洗时间、呼吸抑制、恶心、呕吐、瘙痒等不良反应等指标。结果:50例TURP术后采用CRA疗效确切,镇痛组患者术后6 h、12 h、24 h、48 h VAS评分分别为(0.70±0.62)、(1.02±0.65)、(0.67±0.46)、(0.52±0.43)分,无一例术后出血而再次手术;术后膀胱冲洗时间13～40 h;术后留置导尿时间3～7天;术后呼吸及血压无明显变化。结论:CRA是一种新的TURP术后镇痛方式,对TURP术后镇痛疗效确切,操作安全简单,术后并发症少,值得在临床上推广应用。

Objective：To study on the safety, feasibility and functional mechanism of continous Retzius cavity analgesia（CRA） in the patients after TURP. Methods：Postoperative analgesia was provided for 50 patients undergoing TURP with continous Retzius＇ cavity analgesia. The visual analogue scale（VAS） score in forty-eight hours, the time of bladder perfusion clearance and other complications were recorded. Results：Continous epidural analgesia provided effective postoperative analgesia in 50 patients undergoing TURP. The mean VAS scores at 6 h, 12 h, 24 h, 48 h were（0.70±0.62） ,（1.02±0.65） ,（0.67±0.46） ,（0.52±0.43） respectively. No reoperation and postoperative hemorrhage occurred in all the patients. The time of postoperative continuous bladder irrigation was 13 h to 40 h, and the time of indwelling catheter was 3 days to 7 days. The cardiovascular system and the respiratory system had no obvious changes as compared with those before surgery. Conclusions..Continous Retzius＇ cavity analgesia is a new postoperative analgesia after TURP. The technique has been shown to be easy to perform and it has reliable efficacy, safety and a small incidence of adverse effects.