Tyritzis Stavros I, Stravodimos Konstantinos G, Vasileiou Ioanna, Fotopoulou Georgia, Koritsiadis Georgios, Migdalis Vasileios, Michalakis Anastasios, Constantinides Constantinos A
Department of Urology, Athens University Medical School, LAIKO Hospital, Athens 11527, Greece.
ISRN Urol. 2011;2011:895874. doi: 10.5402/2011/895874. Epub 2011 Jul 12.
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.
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。