Walsh K H, Murphy C, Iohom G, Cooney C, McAdoo J
Cork University Hospital, Department of Anaesthesia, Wilton, Cork, Ireland.
Eur J Anaesthesiol. 2003 Jul;20(7):560-4. doi: 10.1017/s0265021503000899.
Transurethral prostatectomy is routinely performed under spinal anaesthesia. This technique can cause hypotension, which is particularly undesirable in the elderly. The objective was to compare spinal anaesthesia for transurethral prostatectomy using hyperbaric bupivacaine 15 mg (control group) and hyperbaric bupivacaine 10 mg (limiting spread by maintaining the upright position for 15 min) and fentanyl 25 microg (fentanyl group) in terms of haemodynamic and pulmonary function.
Thirty ASA I-III patients were randomly selected and underwent spinal anaesthesia with either hyperbaric bupivacaine 15 mg (immediately positioned supine) or hyperbaric bupivacaine 10 mg (upright for 15 min) and fentanyl 25 microg.
The greatest changes in mean arterial pressure (P = 0.9), ephedrine requirements (P = 0.8) and mean maximum change in forced vital capacity (P = 0.5) were similar in both groups.
The addition of fentanyl 25 microg to bupivacaine 10 mg and limiting the spread of the block does not improve either haemodynamic or pulmonary function compared with bupivacaine 15 mg in patients undergoing transurethral prostatectomy.
经尿道前列腺切除术通常在脊髓麻醉下进行。该技术可导致低血压,这在老年人中尤其不可取。目的是比较在经尿道前列腺切除术中,使用15毫克重比重布比卡因(对照组)、10毫克重比重布比卡因(通过保持直立位15分钟限制阻滞范围)和25微克芬太尼(芬太尼组)进行脊髓麻醉时的血流动力学和肺功能。
随机选择30例ASA I - III级患者,分别接受15毫克重比重布比卡因(立即平卧)或10毫克重比重布比卡因(直立15分钟)加25微克芬太尼的脊髓麻醉。
两组患者的平均动脉压最大变化(P = 0.9)、麻黄碱需求量(P = 0.8)和用力肺活量平均最大变化(P = 0.5)相似。
在接受经尿道前列腺切除术的患者中,与15毫克布比卡因相比,在10毫克布比卡因中添加25微克芬太尼并限制阻滞范围并不能改善血流动力学或肺功能。