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

发布时间：2018-11-19 15:24

【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(P0.05);NV组患者t2时RR和SpO_2较t1时低,差异有统计学意义(P0.05)。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(P0.05)。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。
[Abstract]:Objective to investigate the feasibility and safety of transurethral resection of bladder tumor (TURBt) with new approach of obturator nerve block combined with intravenous anesthesia. Methods Fifty-four patients with bladder tumor were randomly divided into three groups: new approach obturator nerve block combined with vein group (NV group), new approach obturator nerve block combined with lumbar anesthesia group (NS group) and simple spinal anesthesia group (S group), with 18 cases in each group. After entering the operating room (T1), the 3min (T2) and MAP,HR,RR,SpO_2; (T3) at the end of the operation were recorded in the 3 groups. The incidence of obturator nerve reflex, nausea and vomiting, postoperative fasting time, postoperative lower extremity free movement time, hospital stay, and anesthetic satisfaction were recorded in the three groups. Results there was no significant difference in MAP,HR,RR,SpO_2 between the three groups (P0.05). The incidence of obturator nerve reflex in NV,NS group was lower than that in S group, and the anesthetic satisfaction of NV group was higher than that of NS group and S group. The postoperative discharge time of NV group was shorter than that of NS group and S group, the difference was statistically significant (P0.05). Conclusion combined intravenous anesthesia with new approach obturator nerve block can effectively prevent the occurrence of obturator nerve reflex and improve the patients' satisfaction with anesthesia.
【作者单位】：福建中医药大学第五临床医学院三明市第二医院麻醉科;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;福建中医药大学第五临床医学院三明市第二医院信息科;
【基金】：2013年三明市指导性科技项目(2013-S-30)
【分类号】：R614;R737.14

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