Carrouget Julie, Ammi Myriam, Lasocki Sigismond, Lebdai Souhil, Brassart Elena, Geslin Dorothée, Larre Stéphane, Culty Thibaut, Chautard Denis, Azzouzi Abdel Rahmène, Bigot Pierre
Angers University Hospital, Angers, France.
Can J Urol. 2014 Feb;21(1):7120-4.
Ureteral stent placement is a key urologic procedure used to manage ureteral obstructions. It is usually performed under general anesthesia (GA) with its inherent risks. The objective was to evaluate safety, feasibility and tolerance of ureteral stent placement under local anesthesia (LA) in women.
From January 2010 to January 2013, we prospectively and consecutively reviewed all female patients who had an urgent retrograde ureteral stent placement under LA. Only primary stent placements were included in the study. Pain was assessed after surgery by Visual Analog Scale (VAS) and pain and comfort assessment during stent placement were reported. We compared outcomes and tolerance with patients under general anesthesia (GA) matched by age and operatives indications during the same period.
We included 36 patients (18 under LA and 18 under GA) with a mean age of 59.4 +/- 22.4 years. The mean operative time was 24.4 +/- 12.9 min and 18.8 +/- 6.5 min in LA group and GA group (p = 0.110), respectively. One patient needed GA due to a poor tolerance. The mean perioperative VAS scores under LA and GA were 5.89 +/-2.95 and 2.06 +/- 2.67 (p < 0.0001), respectively. There were no intraoperative complications in either group. The procedure was painful for 16 (88.8%) patients from the LA group and 9 (50%) patients would not accept to undergo this intervention under LA again.
Ureteral stent placement under LA in women can be performed safely and effectively. However, this procedure is painful and should be proposed only to selected cases.
输尿管支架置入是治疗输尿管梗阻的一项关键泌尿外科手术。该手术通常在全身麻醉（GA）下进行，存在一定固有风险。本研究旨在评估女性患者在局部麻醉（LA）下进行输尿管支架置入的安全性、可行性及耐受性。
2010年1月至2013年1月，我们对所有在局部麻醉下接受急诊逆行输尿管支架置入的女性患者进行了前瞻性连续研究。本研究仅纳入首次支架置入患者。术后通过视觉模拟评分法（VAS）评估疼痛情况，并报告支架置入过程中的疼痛及舒适度评估结果。我们将研究结果与同期年龄及手术指征相匹配的全身麻醉（GA）患者进行了比较。
我们纳入了36例患者（18例接受局部麻醉，18例接受全身麻醉），平均年龄为59.4±22.4岁。局部麻醉组和全身麻醉组的平均手术时间分别为24.4±12.9分钟和18.8±6.5分钟（p = 0.110）。1例患者因耐受性差而需要全身麻醉。局部麻醉和全身麻醉下围手术期VAS评分的平均值分别为5.89±2.95和2.06±2.67（p < 0.0001）。两组均未发生术中并发症。局部麻醉组有16例（88.8%）患者认为该手术过程疼痛，9例（50%）患者表示不愿再次接受局部麻醉下的该手术。
女性患者在局部麻醉下进行输尿管支架置入可安全有效实施。然而，该手术过程疼痛，仅应推荐给特定病例。
