腰硬联合麻醉在老年前列腺电切术中的应用效果观察

Application of combined spinal-epidural anesthesia in elderly patients undergoing transurethral resection of the prostate

目的探讨腰硬联合麻醉在老年经尿道前列腺电切术中的临床应用效果。方法 60例择期拟行经尿道前列腺电切术的老年患者,随机分为硬膜外麻醉组(EA组)和腰硬联合麻醉组(CSEA组),每组30例;术中监测血压、心率、脉搏、血氧饱和度等,记录麻醉起效时间、阻滞完善时间、阻滞平面和镇痛效果,同时记录术中并发症及不良反应的发生情况。结果 CSEA组比EA组麻醉起效快,阻滞时间较长,镇痛及肌松效果好,差异有统计学意义(P<0.01);麻醉中血流动力学变化和并发症及不良反应的发生情况两组之间比较差异无统计学意义(P>0.05)。结论两种方法均能满足手术要求,其中CSEA应用于老年经尿道前列腺电切术,具有起效快、镇痛确切、用药量少、对循环影响小及术后并发症少等优点。

Objective To investigate the clinical effect of the combined spinal-epidural anesthesia in the elderly transurethral resection of prostate. Methods Sixty patients undergoing transurethral resection of prostate were randomly divided into the epidural anesthesia group （ EA group n = 30） and combined spinal-epidural anesthesia group （CSEA group n = 30）. The blood pressure, heart rate, pulse oximetry, etc. were monitored during operation. The onset time of anesthesia, block perfect time, block plane and analgesia, intraoperative complications and the incidence of ad- verse reactions were recorded. Results Compared with EA group, CSEA group had more rapid onset of anesthesia, a longer block time, better analgesic and muscle relaxant effect （P 〈0. 05）. There were no statistically significant differ- ence in anesthesia complications and bemodynamic changes and incidence of adverse reactions between the two groups （P 〉 0. 05）. Conclusion The two methods can meet the operation requirements. CSEA in the transurethral resection of prostate, has rapider onset of analgesia, less medication, less impact on the circulation and fewer complications.