新径路闭孔神经阻滞复合静脉麻醉在经尿道膀胱肿瘤电切术中的应用  

Application of novel method of obturatornerve block combined with intravenous anesthesia for transurethral resection of bladder tumor

作　　者：肖建芳[1] 吴善苏[1] 王永富[2] 张耀海[3] 

机构地区：[1]福建中医药大学第五临床医学院三明市第二医院麻醉科,永安366000 [2]福建中医药大学第五临床医学院三明市第二医院泌尿外科,永安366000 [3]福建中医药大学第五临床医学院三明市第二医院信息科,永安366000

出　　处：《福建医药杂志》2016年第6期113-116,共4页Fujian Medical Journal

基　　金：2013年三明市指导性科技项目(2013-S-30)

摘　　要：目的探讨新径路闭孔神经阻滞复合静脉麻醉应用于经尿道膀胱肿瘤电切术(TURBt)的可行性及安全性。方法选择择期行膀胱肿瘤电切术患者54例,随机分为新径路闭孔神经阻滞复合静脉组(NV组)、新径路闭孔神经阻滞复合腰麻组(NS组)和单纯腰麻组(S组),每组18例。记录3组进入手术室后(t1)、手术开始3min(t2)、手术结束时(t3)的MAP、HR、RR、SpO_2;记录3组术中闭孔神经反射的发生情况、恶心呕吐发生情况、术后禁食时间、术后下肢自由活动时间、住院天数、患者麻醉满意度。结果 3组患者各时点的MAP、HR、RR、SpO_2比较,差异无统计学意义(P>0.05);NV组患者t2时RR和SpO_2较t1时低,差异有统计学意义(P<0.05)。NV、NS组术中闭孔神经反射的发生率低于S组,NV组患者的麻醉满意度高于NS组和S组,NV组术后出院时间较NS组和S组短,差异均有统计学意义(P<0.05)。结论新径路闭孔神经阻滞复合静脉麻醉应用于TURBt能有效地预防闭孔神经反射发生,提高患者麻醉满意度。Objective To observe the feasibility and safety of novel method of obturatornerve block combined with intravenous anesthesia for transurethral resection of bladder tumor （TURBO. Methods Fifty-four patients undergoing TURBt were randomly divided into the novel method of obturatornerve block combined with intravenous anesthesia group （NV group）, the novel method of obturatornerve block combined with spinal anesthesia group （NS group） and spinal anesthesia group （S group）, with 18 cases each. The vital signs were recorded at before anesthesia （tl）, three minutes after operation （t2） and the end of operation （%） respectively. Incidence of obturatornerve reflex, occurrence of nausea and vomiting, postoperative fasting time, free movement time of the lower limbs, postoperative satisfaction rate and length of hospital stay were observed. Results Patients in three groups did not show significant differences in vital signs （P〉0.05） s respiratory rate and SpO2 in NV group were lower at t2 than those at t1 （P〈0.05）. The incidence of obturatornerve reflex in NS group and NV group was lower than that in S group （P〈0.05）. The satisfaction rate in NV group was higher than that in NS group and S group （P〈0.05）. The length of hospital stay in NV group was shorter than that in group NS and group S （P〈0.05）. Conclusion The novel method of obturator nerve block combined with intravenous anesthesiacan is effective and increases patient satisfaction for TURBt.

关 键 词：闭孔神经阻滞 静脉麻醉 经尿道膀胱肿瘤电切术 新径路 

分 类 号：R614[医药卫生—麻醉学]