Reisli R, Celik J, Tuncer S, Yosunkaya A, Otelcioglu S
University of Selcuk, Faculty of Medicine, Department of Anaesthesiology, Konya, Turkey.
Eur J Anaesthesiol. 2003 Jan;20(1):26-30. doi: 10.1017/s026502150300005x.
To compare, using prilocaine, the effects of continuous spinal anaesthesia (CSA) and continuous epidural anaesthesia (CEA) on haemodynamic stability as well as the quality of anaesthesia and recovery in patients undergoing transurethral resection of the prostate gland.
Thirty patients (>60 yr) were randomized into two groups. Prilocaine, 2% 40 mg, was given to patients in the CSA group, and prilocaine 1% 150mg was given to patients in the CEA group. Incremental doses were given if the level of sensory block was lower than T10 or if needed during surgery.
There was a significant decrease in mean arterial pressure in Group CEA compared with Group CSA (P < 0.01). The decrease in heart rate in Group CSA occurred 10 min after the first local anaesthetic administration and continued through the operation (P < 0.05). The level of sensory anaesthesia was similar in both groups. The times to reach the level of T10 and the upper level of sensory blockade (Tmax) were 18.0 +/- 4.7 and 25.3 +/- 7.0 min in Groups CSA and CEA, respectively, and were significantly longer in Group CEA. The duration of anaesthesia was 76.8 +/- 4min and was shorter in Group CSA (P < 0.01).
Spinal or epidural anaesthesia administered continuously was reliable in elderly patients undergoing transurethral resection of the prostate. Continuous spinal anaesthesia had a more rapid onset of action, produced more effective sensory and motor blockade and had a shorter recovery period. Prilocaine appeared to be a safe local anaesthetic for use with either continuous spinal anaesthesia or continuous epidural anaesthesia.
使用丙胺卡因比较连续脊麻（CSA）和连续硬膜外麻醉（CEA）对接受经尿道前列腺切除术患者血流动力学稳定性、麻醉质量及恢复情况的影响。
30例年龄>60岁的患者被随机分为两组。CSA组患者给予2%丙胺卡因40mg，CEA组患者给予1%丙胺卡因150mg。如果感觉阻滞平面低于T10或手术期间需要，则给予递增剂量。
与CSA组相比，CEA组平均动脉压显著降低（P<0.01）。CSA组心率在首次给予局部麻醉药后10分钟开始下降，并持续至手术结束（P<0.05）。两组感觉麻醉水平相似。CSA组和CEA组达到T10水平和感觉阻滞上限（Tmax）的时间分别为18.0±4.7分钟和25.3±7.0分钟，CEA组明显更长。麻醉持续时间为76.8±4分钟，CSA组更短（P<0.01）。
连续给予脊麻或硬膜外麻醉对接受经尿道前列腺切除术的老年患者是可靠的。连续脊麻起效更快，产生更有效的感觉和运动阻滞，恢复期更短。丙胺卡因似乎是一种安全的局部麻醉药，可用于连续脊麻或连续硬膜外麻醉。
