Gunter J B, Forestner J E, Manley C B
Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri.
J Urol. 1990 Aug;144(2 Pt 2):517-9; discussion 530.
We studied 24 boys who were randomized to receive caudal epidural anesthesia with 0.33 ml.kg.-1 0.25% bupivacaine either before (group A) or after (group B) Mathieu repair of distal hypospadias. The 2 groups did not differ in regard to age or weight, and all boys received a standardized anesthetic with halothane and nitrous oxide in oxygen. Intraoperative blood loss was measured with sponge weights and microcalibrated suction canisters. Halothane requirements were reduced in group A (0.5 versus 1.1 plus or minus 0.1%, p less than 0.001). Measured blood loss was reduced in group A (16 plus or minus 10 ml. versus 31 plus or minus 17 ml., p less than 0.01). Operating time was reduced in group A (92 plus or minus 13 minutes versus 103 plus or minus 14 minutes, p less than 0.05). There was no apparent difference in postoperative pain relief between the 2 groups. We conclude that caudal epidural anesthesia can reduce blood loss and improve surgical conditions during hypospadias repair.
我们研究了24名男孩，他们被随机分为两组，在远端尿道下裂的马蒂厄修复术前（A组）或术后（B组）接受0.33 ml.kg.-1的0.25%布比卡因骶管硬膜外麻醉。两组在年龄或体重方面没有差异，所有男孩均接受以氟烷和一氧化二氮加氧气的标准化麻醉。术中失血量通过海绵重量和微量校准的吸引罐进行测量。A组的氟烷需求量减少（0.5%对1.1%±0.1%，p<0.001）。A组测量的失血量减少（16±10 ml对31±17 ml，p<0.01）。A组的手术时间缩短（92±13分钟对103±14分钟，p<0.05）。两组术后疼痛缓解情况无明显差异。我们得出结论，骶管硬膜外麻醉可减少尿道下裂修复术中的失血量并改善手术条件。
