老年人前列腺增生症经尿道前列腺电汽化术的麻醉与电切综合征的早期诊断.docVIP

老年人前列腺增生症经尿道前列腺电汽化术的麻醉与电切综合征的早期诊断…尤新民等 (182) 文章已被阅读 1202 次添加时间：2003/10/14 10:49pm　添加者：山东麻醉论坛 《中国麻醉与镇痛》杂志2002-03－182 【摘要】目的：探讨小剂量轻比重布比卡因腰麻用于老年人TVP手术的麻醉效果，探讨其并发TURS的早期诊断。方法：选择100例老年TVP病人，在0.1%布比卡因5mg腰麻下施术，术中监测BP、HR、SpO2、ECG。用i-STAT监测血糖、电解质、血气、Hct和Hb。用超声多普勒心功能监测仪经胸骨上测定心功能。结果：全组病人的麻醉效果完善，术中循环呼吸功能稳定，与术前比较P＞0.05。术中血糖明显升高(P＜0.01)。术中60 min、术毕和术后的血钠均比术前下降(P＜0.05)。术中30 min和术毕的CO比术前分别下降11.5%(P＜0.05)和9.8；SVR分别升高7.3%和14.9%(P＜0.05)。结论：小剂量轻比重布比卡因腰麻用于TVP手术，安全可靠，能适应手术头低体位，术中心功能影响轻微。术中和术后监测血糖，可早期发现TURS。 【关键词】老年经尿道前列腺电汽化术(TVP)腰麻，布比卡因，轻比重液电切综合征(TURS） Anaesthesia for TVP in elderly and Early Diagnosis of TURS. You Xinmin, Han Ling, Chen Yiqi, et al. Department of Anesthesiology, Xin Hua Hospital, Shanghai Second Medical University, Shanghai 200092, China. 【Abstract】ObjectiveTo evaluate the effects of spinal anaesthesia with small dosage of hypobaric bupivacaine in elderly TVP patients and to study the early diagnosis of TURS. ?MethodsOne hundred elderly TVP patients were performed under spinal anaesthesia with hypobaric 0.1% bupivacaine 5 ml. BP, HR, SpO2 and ECG were monitored and the blood sugar, blood-gas analysis, Hct and Hb were measured by I-STAT monitor. The cardiac function was monitered with ultrasonic doppler monitor suprasternally. ?ResultsThe anaesthetic effects for all patients were well and the circulatory and respiratory functions were stable (P＞0.05). The blood sugar levels were increased significantly during operation (P＜0.01). The blood Na+ levels at 60 min during operation and the end of operation and postoperative period decreased significantly (P＜0.05). CO decreased by 11.5% (P＜0.05) 30 min during operation and 8% at the end of operation respectively. SVR increased 17.3% and 14.9% (P＜0.05) respectively. ConclusionSmall dosage hypobaric bupivacaine spinal anaesthesia is a safe and reliable method for TVP operation. The early diagnosis of TURS can be made by monitoring the blood sugar levels.  【Key words】Aged; TVP; Spinal anaesthesia, hypob