不同麻醉方法下行经尿道输尿管软镜钬激光碎石术的研究

Study on different methods of anesthesia for flexible ureteroscopy with holmium laser lithotripsy

目的研究腰-硬联合椎管内阻滞麻醉(CSEA)与静吸复合全身麻醉(GA)两种麻醉方法对行经尿道输尿管软镜碎石术(RIRS)的影响。方法按随机原则选择70例拟行RIRS的患者,依麻醉方法不同分为CSEA(C组)、GA(G组)两组,每组35例。比较C、G两组患者术后6 h和24 h视觉模糊疼痛评分(VAS);手术时间;统计麻醉费用;术中及术后6h以内心动过缓、低血压、术中镇痛不全、恶心、呕吐、寒战并发症的总发生率。结果 C、G两组患者都顺利完成手术;两组手术时间、手术后6 h、24 h VAS评分、麻醉并发症的总发生率无统计学差异;CSEA组比GA组麻醉费用低。结论 CSEA与GA两种麻醉方法均可安全用于RIRS,CSEA比GA麻醉费用低。

Objective To research the effect of different anesthesia ( general anesthesia GA and combinedspinal-epiduralanesthesia CESA ) for flexible ureteroscopy with holmium laser lithotripsy .Methods Seventy patients need for RIRS were randomly assigned to CSEA group and GA group (n=35).The postoperative VAS ( with 6h and 24 h) and operating time and the cost of anesthesia and the intraoperative and postoperative complications were record .Results All operation were successfully .No significant differences were found in operation time and postoperative VAS ( with 6h and 24 h ) and the incidence of postoperative complications between two groups .In CESA grougp , the cost of anesthesia were lower than that in GA group .Conclusions CESA and GA are safe for flexible ureteroscopy with holmium laser lithotripsy .CSEA anesthesia costs less than GA.