Olsfanger D, Zohar E, Fredman B, Richter S, Jedeikin R
Department of Anesthesiology and Intensive Care, Meir Hospital, Kfar Saba, Israel.
J Clin Anesth. 1999 Jun;11(4):328-31. doi: 10.1016/s0952-8180(99)00057-4.
To evaluate the influence of spinal versus general anesthesia on bladder compliance and intraabdominal pressure in elderly males undergoing elective transurethral resection of the prostate.
Prospective, randomized, open-label study.
Teaching hospital.
21 ASA physical status I, II, and III patients at least 18 years of age, undergoing transurethral surgery.
According to a computer-generated randomization schedule, patients were allocated to one of two groups. In Group Spinal (S), 10 mg of hyperbaric tetracaine was administered intrathecally. In Group General Anesthesia (GA), patients received, fentanyl intravenous (i.v. 1 to 2 micrograms/kg and propofol i.v. 1.0 to 2.0 mg/kg for induction of anesthesia. Thereafter, a laryngeal mask airway was inserted and, with spontaneous ventilation, anesthesia was maintained by administering isoflurane (end-tidal 0.7% to 1.2%) and 70% nitrous oxide (N2O) in oxygen. Intraabdominal pressure and bladder compliance were recorded prior to the induction of anesthesia and immediately before the onset of the surgical procedure.
The two groups were demographically comparable. In Group S, mean bladder compliance was significantly (p = 0.003) higher and mean intraabdominal pressure significantly lower (p = 0.007) when compared to baseline preanesthetic values. In Group GA, mean intraabdominal pressure significantly (p = 0.006) decreased when compared to baseline preanesthetic recordings. Following the induction of general anesthesia, a small change in bladder compliance was noted. However, statistical significance was not reached. Data were analyzed and compared using Student's t-test (p < 0.05 was considered statistically significant).
Both spinal and general anesthesia induced a significant decrease in intraabdominal pressure. While both techniques were associated with an increase in bladder compliance, statistical significance was demonstrated only in the spinal anesthesia treatment group.
评估脊髓麻醉与全身麻醉对择期行经尿道前列腺切除术老年男性膀胱顺应性和腹内压的影响。
前瞻性、随机、开放标签研究。
教学医院。
21例年龄至少18岁、美国麻醉医师协会（ASA）身体状况为I、II和III级、接受经尿道手术的患者。
根据计算机生成的随机分组方案，患者被分配至两组之一。脊髓麻醉组（S组），鞘内注射10mg重比重丁卡因。全身麻醉组（GA组），患者静脉注射芬太尼（1至2微克/千克）和丙泊酚（1.0至2.0毫克/千克）诱导麻醉。此后，插入喉罩气道，在自主通气下，通过吸入异氟烷（呼气末浓度0.7%至1.2%）和70%氧化亚氮（N2O）与氧气维持麻醉。在麻醉诱导前及手术开始前即刻记录腹内压和膀胱顺应性。
两组在人口统计学上具有可比性。与麻醉前基线值相比，S组平均膀胱顺应性显著更高（p = 0.003），平均腹内压显著更低（p = 0.007）。与麻醉前基线记录相比，GA组平均腹内压显著降低（p = 0.006）。全身麻醉诱导后，膀胱顺应性有微小变化，但未达到统计学显著性。数据采用Student's t检验进行分析和比较（p < 0.05被认为具有统计学显著性）。
脊髓麻醉和全身麻醉均导致腹内压显著降低。虽然两种技术都与膀胱顺应性增加有关，但仅在脊髓麻醉治疗组显示出统计学显著性。
