腰麻-硬膜外联合麻醉和硬膜外麻醉在高龄患者经尿道前列腺电切术中的比较分析

Comparative analysis of spinal-epidural combined anesthesia and epidural anesthesia in the elderly patients undergoing transurethral resection of prostate

目的探讨腰麻-硬膜外联合麻醉和硬膜外麻醉在高龄患者经尿道前列腺电切术中的比较情况。方法选取我院2014年5月~2016年6月收治的90例经尿道前列腺电切术患者,依据麻醉方式不同分为联合麻醉组(50例)和硬膜外麻醉组(40例)。联合麻醉组采用腰麻-硬膜外联合麻醉,硬膜外麻醉组采用硬膜外麻醉。观察两组不同时间点的收缩压、舒张压情况,记录两组的麻醉起效时间、阻滞完善时间及术毕最高感觉阻滞平面情况,比较两组的麻醉效果。结果两组麻醉后、5 min、10 min、15 min、20 min的收缩压和舒张压比较,差异无统计学意义(P>0.05)。联合麻醉组的麻醉起效时间、阻滞完善时间均短于硬膜外麻醉组,麻醉效果优良率高于硬膜外麻醉组,差异有统计学意义(P<0.05)。结论腰麻-硬膜外联合麻醉在高龄患者经尿道前列腺电切术中应用,可以缩短麻醉起效时间,麻醉效果明显,值得临床推广应用。

Objective To investigate the comparison of spinal-epidural combined anesthesia and epidural anesthesia in the elderly patients undergoing transurethral resection of prostate.Methods 90 patients undergoing transurethral resection of prostate from May 2014 to June 2016 in our hospital were selected and divided into the combined anesthesia group（50 cases） and the epidural anesthesia group（40 cases） according to different anesthesia methods.The combined anesthesia group was given spinal-epidural combined anesthesia, and the epidural anesthesia group was given epidural anesthesia.The systolic and diastolic blood pressures at different time points in the two groups were observed.The anesthesia onset time,completion time of blockage,the highest sensory block plane after surgery in the two groups were recorded,and anesthesia effect were compared in the two groups.Results There was no significant difference in the systolic and diastolic blood pressure after anesthesia,at 5 min,10 min,15 min and 20 min between the two groups（P〉0.05）.The onset time of anesthesia and completion time of blockage in the combined anesthesia group were both lower than those in the epidural anesthesia group,the excellent and good rate of anesthesia in the combined anesthesia group was higher than that in the epidural anesthesia group,with significant difference（P〈0.05）.Conclusion The application of spinal-epidural combined anesthesia in the elderly patients undergoing transurethral resection of prostate can shorten the onset time of anesthesia,with a significant effect of anesthesia,which is worthy of clinical promotion and application.