脊麻-硬膜外联合麻醉在老年患者前列腺电汽化术中的应用

The application of combined spinal-epidural anesthesia in electrovaporization of porostate in the elder patients

目的 探讨脊麻 -硬膜外联合麻醉 (CSEA)在老年人经尿道前列腺电汽化术 (TUVP)中应用的可行性。方法 对 70例 6 0岁以上老年人 ASA ～ 级 ,在 CSEA下行 TUVP,连续监测 NIBP.ECG.SPO2 ,记录麻醉前、后 ,手术开始、手术结束四个时点的 MAP、HR、SPO2 。结果 麻醉优良率为 10 0 %。起效时间为 8.2 7± 2 .2 min,四个时点的 MAP无明显变化 (P>0 .0 5 ) ,麻醉前、后 HR有明显变化 (P<0 .0 1) ,其余时点 HR无明显变化 (P>0 .0 5 ) ,SPO2 均在 99%以上。结论 CSEA对老年人 TUVP具有安全性大、局麻药量少 ,阻滞完善 ,对全身影响小 ,是一种可行的麻醉方法。

Objective To explore the effect of combined spinal epidural anesthesia(CSEA) in the aged undergoing transurthreal electrovaporization of prostate(TUVP).Methods Seventy elder patients,ASAⅡ～Ⅲ,undergoing TUVP under CSEA were observed while NIBP,ECG and SPO 2 were monitored continuously.The changes of MAP,HR,SPO 2 at the time points of pre anesthesia,post anesthesia,initial operation and post operation were recorded.Results Analgesia effect in all patient were very satisfactory.The onest of anesthesia was 8.27±2.2 min.There were no differences of MAP at four time points( P >0.05).HR were significant differences between preanesthesia and post anesthesia( P <0.01) while HR at the other time points had no significant changes( P >0.05).SPO 2 of all patients were≥99%.Conclusion CSEA in the aged undergoing TVVP is a safe and effective method with the advantages of less local anesthetic,perfect nerve block and little influence to the whole body.