经尿道等离子体双极电切行前列腺切除术麻醉体会  

Comprehension of the anesthesia of per urethra prostatectomy with plasms body dipolar electro scalpel

作　　者：王立文[1] 杨焕杰[1] 梁华[1] 马秀光[1] 贺雅琳[1] 马彩军 杨少春[1] 袁利邦[1] 郭永军[1] 

机构地区：[1]解放军第五医院,宁夏银川750004

出　　处：《宁夏医学杂志》2006年第1期17-19,共3页Ningxia Medical Journal

摘　　要：目的探讨布比卡因等比重液腰-硬联合阻滞经尿道等离子体双极电切行前列腺切除术(PKVP)的效果。方法225例ASAⅠ-Ⅱ级PKVP病人,行腰-硬联合阻滞麻醉。分别于术前、手术30分钟、60分钟及术后60分钟采集静脉血,监测血糖和电解质。术后行硬膜外自控镇痛(PCEA),镇痛效果采用视觉模拟评分法(VAPS)。结果腰麻起效时间1-3分钟,麻醉平面固定时间15-20分钟,痛觉阻滞平面T5-10-S5。腰麻后30分钟血压下降明显(P<0.05),快速补液或给予麻黄碱即可纠正。血糖和钾、钠、氯变化无显著性差异(P>0.05)。术后镇痛VAPS为3-5.5分,总优良率为93.3%。结论0.75%布比卡因等比重液腰-硬联合阻滞麻醉用于PKVP是安全和有效的。Objective To determine the clinical efficacy and safery of isobarie bupivaeaine for combined spinal- epidural anesthesia （CSEA） during the transurethral plasma kinetic vaporization of prostate （PKVP）. Methods 225 patients, graded ASA Ⅰ - Ⅱ, aged from 35 - 87years old（69.19 ＋ 10.40）, accepted CSEA puncture at the L2-4 spinal space with isobaric solution 0.8 - 1.5ml of 0.75% bupivacaine for subarachnoid anesthesia. Blood sample were taken before operation and at 30 rain, 60 min during the operation and 60 rain postoperatively through venous and blood sugar and dielectric were monitored. Patient controlled epidural analgesia （PCEA） was used to kill postoperative pain and the effect was valued by visual analcgue pain scale （VAPS）. Results The onset of anesthesia was 1 - 3 rain and the block level was between T5 - 10 - S5 region. Alter spinal block 30min, blood pressure decreased significantly （ P 〈 0.05 ）, and reversed by 15 - 30mg of ephedrine. All patients had no any serious complication during the operation. VAPS was 3 - 5.5 points. There was no significant difference of serum glucose and serum electrolyte between the preoperative and intraoperative parameters. Conclusion Isobaric solution of 0. 75 % Bupivacaine is safe and effective for CSEA in the PKVP.

关 键 词：布比卡因 等比重液 腰-硬联合阻滞 前列腺增生 等离子体双极电切手术 

分 类 号：R614[医药卫生—麻醉学]