腰硬联合麻醉在老年患者经尿道前列腺电切术50例麻醉体会

Combined Spinal-Epidural Anesthesia in Elderly Patients with Transurethral Resection of 50 Cases of Anesthesia

目的：观察腰硬联合麻醉在老年前列腺电切术中应用的安全性。方法：对50例经尿道前列腺电切术患者，在腰硬联合麻醉下施行手术，L2-3间隙或L3-4腰椎间隙穿刺，见脑脊液后注入0．75％布比卡因1．5ml加10％葡萄糖lml，硬膜外向上置管3cm。结果：50例患者麻醉效果均满意，麻醉前、麻醉后血压、心率、氧饱和度比较差异无统计学意义（P〉0．05），术中无呼吸抑制、恶心、呕吐及术后头痛发生，均顺利完成手术，有3例出现稀释性低钠血症表现者，经治疗后均安全好转。结论：前列腺增生的老年患者，常同时合并多种内科疾病，故要做好充分的手术前准备，应用小剂量0．75％布比卡因重比重液腰硬联合麻醉效果确切，安全可靠，对患者心肺功能影响小，可安全有效地用于前列腺电切患者，同时要注意术中稀释性低钠血症的防治。

Objective.. To observation combined spinal-epidural anesthesia in elderly transurethral resection of the pros- tate application security, methods, 50 cases of transurethral resection in patients with combined spinal-epidural anesthe- sia in an operation, L2-3 or L2-4 clearance puncture lumbar intervertebral, see the cerebrospinal fluid after the injection of 1. 5ml of 0. 75% bupivacaine plus 10% glucose lml, epidural catheter up 3cm. Results： 50 patients were satisfied with the anesthetic effect, before anesthesia, anesthesia, blood pressure heart rate. Oxygen saturation difference was not statistically significant （P〉 0. 05）, were no respiratory depression, nausea, vomiting and postoperative headache, were successfully completed surgery, 3 cases dilutional hyponatremia performers after treatment are safe and im- proved. Conclusion： Elderly patients with benign prostatic hyperplasia,often while patients with multiple medical prob- lems, it should make full preparation before surgery, a small dose of 0. 75% hyperbaric bupivacaine combined spinal- epidural anesthesia was the exact effect, safe and reliable, on Cardiopulmonary function in patients with little effect can be safely and effectively used in transurethral resection of prostate patients, keeping in mind intraoperative dilutional hyponatremia prevention.