椎管内麻醉和全身麻醉对老年前列腺电切术患者的影响

Influence of Intraspinal Anesthesia and General Anesthesia on Elderly Patients Undergoing Electro-prostatectomy

目的:探讨椎管内麻醉、全身麻醉对老年前列腺电切术患者的影响。方法:选取2016年12月-2019年12月本院146例接受前列腺电切术的老年前列腺增生(BPH)患者。按照麻醉方式分为全麻组和椎管麻醉组,各73例。全麻组采用全身麻醉,椎管麻醉组接受椎管内麻醉。比较两组麻醉前(T0)、切皮时(T1)、术毕即刻(T2)平均动脉压(MAP)、心率(HR),睁眼时间、语言陈述时间及术前、术后6 h简易智能精神状态检查量表(MMSE)评分。结果:T0时,两组MAP、HR比较差异无统计学意义(P>0.05),T1、T2时,椎管麻醉组MAP、HR低于全麻组(P<0.05)。与全麻组比较,术后6 h椎管麻醉组MMSE评分较高(P<0.05);椎管麻醉组睁眼时间、语言陈述时间早于全麻组(P<0.05)。结论:相较于全身麻醉,椎管内麻醉有利于稳定老年BPH患者前列腺电切术中血流动力学,缩短睁眼时间、语言陈述时间,改善认知功能。

Objective:To investigate the influence of intraspinal anesthesia and general anesthesia on elderly patients undergoing electro-prostatectomy.Method:A total of 146 elderly patients with benign prostatic hyperplasia (BPH) who underwent electro-prostatectomy from December 2016 to December 2019 in our hospital were selected.According to the method of anesthesia,the patients were divided into the general anesthesia group and the spinal anesthesia group,73 cases in each group.The general anesthesia group received general anesthesia,the spinal anesthesia group received intraspinal anesthesia.The mean arterial pressure (MAP) and heart rate (HR) before anesthesia (T0),skin incision (T1),and immediately after surgery (T2),eye-opening time,the time of speech statement and the mini-mental state examination (MMSE) scores before and 6 h after surgery were compared between the two groups.Result:At T0,there were no statistically significant differences in MAP and HR between the two groups (P>0.05),the MAP and HR of the spinal anesthesia group was lower than those of the general anesthesia group at T1 and T2 (P<0.05).Compared with the general anesthesia group,the MMSE score of the spinal anesthesia group was higher at 6 h after operation (P<0.05).The time of eye-opening and speech statement in the spinal anesthesia group was earlier than those in the general anesthesia group (P<0.05).Conclusion:Compared with general anesthesia,intraspinal anesthesia is beneficial to stabilize the hemodynamics of the elderly undergoing electro-prostatectomy,shorten the time of eye-opening,speech statement time,and improve cognitive function.