小剂量利多卡因腰-硬联合麻醉在老年人前列腺绿激光手术中的应用

Anesthesia effects of spinal-epidural anesthesia with low-dose lidocaine for prostate green laser surgery in elderly patients

目的:观察腰-硬联合麻醉(CSEA)应用于老年人前列腺绿激光的临床麻醉效果。方法:160例老年人经尿道前列腺绿激光汽化术患者,随机分为CSEA组和硬膜外麻醉(EA)组,各80例。穿刺点选择L3～4,CSEA组蛛网膜下腔注入2%利多卡因0.8～1mL,并根据手术时间硬膜外腔追加1.6%利多卡因;EA组硬膜外腔推注1.6%利多卡因。持续监测生命体征变化并评定麻醉效果。结果:CSEA组麻醉起效快、阻滞完全,局麻药用量少,生命体征平稳,麻醉效果优于EA组。结论:小剂量利多卡因腰-硬联合麻醉在经尿道前列腺绿激光汽化术中的应用,是一种安全有效的麻醉方式。

Objective： To observe the anesthesia effects of spinalepidural anesthesia with low-dose lidocaine for prostate green laser surgery in elderly patients. Methods. A total of 160 elderly patients scheduled for transurethral prostate green laser vaporization were randomly divided into the CSEA group （n=80） and epidural anesthesia group （EA group, n=80）. L3-4 was selected as puncture point, CSEA group was given subarachnoid injection of 2% lidocaine 0. 8-1 mL, an additional 1.6% lidocaine could subarachnoid injected if necessary; EA group was given epidural injection 1 6% lidocaine. Continuous mo- nitoring of vital signs and assessment of anesthetic effect were conducted. Results： CSEA group showed rapid onset of anesthesia, complete block and stable vital signs. CSEA group had better anesthesia effects but consumed smaller does of lidocaine than group EA. Conclusions： Anesthesia effects of spinal - epidural anesthesia with low-dose lidocaine is great for prostate green laser surgery in elderly patients.