利多卡因阴茎局部神经阻滞麻醉治疗全身麻醉后阴茎异常勃起效果研究

Effect of lidocaine penis local nerve blocking anesthesia on abnormal erection of penis after general anesthesia

目的观察利多卡因阴茎局部神经阻滞治疗全身麻醉(全麻)后发生阴茎异常勃起的有效性及安全性。方法选取2019年7月1日至2021年5月31日该院泌尿外科收治的经尿道内窥镜择期手术患者1276例,全麻后经尿道内窥镜操作前发生阴茎勃起患者38例,采用简单随机方式分为空白对照组(A组,12例)、研究组(B组,13例)和对照组(C组,13例)。A组无处理,静待勃起自行疲软;B组给予2%盐酸利多卡因注射液5 mL,分别在阴茎根部背侧神经支注射3 mL及会阴神经支注射2 mL;C组给予生理盐水5 mL,分别在阴茎根部背侧神经支注射3 mL及会阴神经支注射2 mL。观察并记录3组患者阴茎完全疲软所需时间。结果B组患者勃起至疲软时间均较A、C组明显缩短,差异均有统计学意义(P<0.05);A组患者勃起至疲软时间与C组比较,差异无统计学意义(P>0.05)。结论全麻后患者发生阴茎异常勃起时采用2%盐酸利多卡因注射液5 mL分别在阴茎根部背侧神经支注射3 mL及会阴神经支注射2 mL可获得快速显著的疗效,且不会引起勃起功能障碍。

Objective To observe the efficacy of lidocaine penile local nerve block in the treatment of priapism after general anesthesia.Methods A total of 1276 patients with transurethral endoscopic elective surgery treated in the urological surgery of this hospital from July 1,2019 to May 31,2021 were selected,38 cases of penile erection before transurethral endoscopic operation after general anesthesia were divided into the black control group(group A,12 case),study group(group B,13 cases)and control group(group C,13 cases)by the simple random method.The group A had no treatment,waiting until the erection weakening on its own;the group B was given 5 mL of 2%lidocaine hydrochloride injection,3 mL was injected by the dorsal nerve branch of penis root and 2 mL by perineal nerve branch respectively;the group C was given 5 mL of normal saline,3 mL was injected by dorsal nerve branch of penis root and 2mL by perineal nerve branch respectively.The time until complete weakening of the penis erection was observed and recorded.Results The time of erection to weakening in the group B was significantly shortened compared with that in the group A and C,and the difference was statistically significant(P<0.05),but which had no statistically significant difference between the group A and C(P>0.05).Conclusion When the patients have priapism after general anesthesia,5 mL 2%lidocaine hydrochloride injection is adopted to be injected by 3mL in the dorsal nerve branch of the penis root and 2mL in the perineal nerve branch,which can obtain rapid and significant therapeutic effect,moreover without causing erectile function disorder.