Shimodate Y, Dobashi N, Kudo A, Shinozaki Y, Matsuki A
Department of Anesthesiology, University of Hirosaki School of Medicine.
Masui. 1990 Oct;39(10):1409-12.
A case of priapism following epidural anesthesia was reported. A 67 year old man received epidural anesthesia for the transurethral resection of a malignant bladder tumor. Epidural anesthesia which he had wanted to receive was given through the L3 to L4 intervertebral space with 18 ml of 2% lidocaine. The penile erection occurred while he was prepared and draped. Additional 8 ml of 1% lidocaine failed to overcome it and the operation cancelled. After this episode, he had anesthesia on 5 occasions in 2 years. General anesthesia was given 3 times without penile erection, but epidural block was tried on 2 occasions, which was followed by penile erection. For the penile erection, intracavernous injection of etilefrine hydrochloride was effective and surgical procedure could be done smoothly. The mechanism of priapism remained unclear but imbalance of the autonomic nervous system may be a involved. This case suggests that intracavernous injection of etilefrine hydrochloride is effective for treatment of penile erection during transurethral surgery.
报道了1例硬膜外麻醉后发生阴茎异常勃起的病例。一名67岁男性因经尿道切除恶性膀胱肿瘤接受硬膜外麻醉。通过L3至L4椎间隙给予其希望接受的硬膜外麻醉,使用18毫升2%利多卡因。在他被准备和铺巾时阴茎勃起。额外给予8毫升1%利多卡因未能消除勃起,手术取消。在此事件后,他在2年内接受了5次麻醉。3次给予全身麻醉时未出现阴茎勃起,但尝试了2次硬膜外阻滞,随后均出现阴茎勃起。对于阴茎勃起,海绵体内注射盐酸乙苯福林有效,手术得以顺利进行。阴茎异常勃起的机制尚不清楚,但自主神经系统失衡可能与之有关。该病例表明,海绵体内注射盐酸乙苯福林对经尿道手术期间的阴茎勃起治疗有效。