高龄患者行前列腺电汽化术的麻醉处理

Anaesthesia management for prostate gland electrification in senile patients

目的 观察硬膜外阻滞与静吸全麻于前列腺电汽化术中的麻醉效果、术中管理及术后并发症。方法 选择70岁以上行前列腺电汽化术患者60例,随机分为两组:Ⅰ组采取硬膜外阻滞,Ⅱ组采取静吸全麻,以异丙酚1.5～2.0mg/kg,芬太尼0.02～0.03mg/kg,呵端0.05～0.08mg/kg快速诱导插管,异氟醚1～1.5％维持麻醉。两组术后均给以患者自控镇痛。结果 两组麻醉效果均满意,无统计学差异。术中管理,Ⅰ组易于Ⅱ组,术后并发症,Ⅰ组3例,占10％,Ⅱ组22例,占73％,两组差别有显著性意义(P<0.05)。结论 硬膜外阻滞用于高龄患者行前列腺电汽化术的麻醉,效果确切,术后并发症少,便于管理,更有临床使用价值。

Objective To compare the effect of epidural anesthesia and general anesthesia, management during operation, and complication after operation in prostate gland electrification. Methods 60 cases of senile patient over 70 years old taking prostate gland electrification were divided into two groups randomly. In first group, epidural anesthesia was used. After puncturing and laying a tube, a little amount of 1 .33 % lidocaine was given for several times. In the second group general anesthesia was used. Propofol 1.5 - 2.0mg/kg, fentanyl 0.02 - 0.03mg/kg and pancuroni-um 0.05 - 0.08mg/kg were injected for inducing and trachea! tube was inserted guickly. Isoflurane 1 - 1.5% inhalation was used for sustaining the anesthesia. Patient-controlled analgesia was given after operation in both group. Results Two anaesthesia scheme gave satisfactory effect, with no difference statistically. Management during the operation in the first group was easier than that in the second group.There were 3 cases( 10% ) with postoperative complication in the first group but 22 cases(70% ) in the second group. The difference between the two groups was significant statistically ( P < 0. 05) . Conclusion The epidural anesthesia is more satisfactory , fewer complications and easy for clinical nursing.