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经尿道手术术后疼痛管理中脊髓麻醉与全身麻醉的比较

Spinal versus General Anaesthesia in Postoperative Pain Management during Transurethral Procedures.

作者信息

Tyritzis Stavros I, Stravodimos Konstantinos G, Vasileiou Ioanna, Fotopoulou Georgia, Koritsiadis Georgios, Migdalis Vasileios, Michalakis Anastasios, Constantinides Constantinos A

机构信息

Department of Urology, Athens University Medical School, LAIKO Hospital, Athens 11527, Greece.

出版信息

ISRN Urol. 2011;2011:895874. doi: 10.5402/2011/895874. Epub 2011 Jul 12.

Abstract

We compared the analgesic efficacy of spinal and general anaesthesia following transurethral procedures. 97 and 47 patients underwent transurethral bladder tumour resection (TUR-B) and transurethral prostatectomy (TUR-P), respectively. Postoperative pain was recorded using an 11-point visual analogue scale (VAS). VAS score was greatest at discharge from recovery room for general anaesthesia (P = 0.027). The pattern changed significantly at 8 h and 12 h for general anaesthesia's efficacy (P = 0.017 and P = 0.007, resp.). A higher VAS score was observed in pT2 patients. Patients with resected tumour volume >10 cm(3) exhibited a VAS score >3 at 8 h and 24 h (P = 0.050, P = 0.036, resp.). Multifocality of bladder tumours induced more pain overall. It seems that spinal anaesthesia is more effective during the first 2 postoperative hours, while general prevails at later stages and at larger traumatic surfaces. Finally, we incidentally found that tumour stage plays a significant role in postoperative pain, a point that requires further verification.

摘要

我们比较了经尿道手术后脊髓麻醉和全身麻醉的镇痛效果。分别有97例和47例患者接受了经尿道膀胱肿瘤切除术(TUR-B)和经尿道前列腺切除术(TUR-P)。术后疼痛采用11点视觉模拟量表(VAS)记录。全身麻醉患者从恢复室出院时VAS评分最高(P = 0.027)。全身麻醉效果在8小时和12小时时模式发生显著变化(分别为P = 0.017和P = 0.007)。pT2患者的VAS评分更高。肿瘤切除体积>10 cm³的患者在8小时和24小时时VAS评分>3(分别为P = 0.050,P = 0.036)。膀胱肿瘤的多灶性总体上会引起更多疼痛。似乎脊髓麻醉在术后前2小时更有效,而全身麻醉在后期和创伤面较大时占优势。最后,我们偶然发现肿瘤分期在术后疼痛中起重要作用,这一点需要进一步验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d135/3195316/1f1a54d65487/UROLOGY2011-895874.001.jpg

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