绿光激光经尿道前列腺切除术期间突然发生低血压和心动过缓：两例病例报告
Sudden occurence of hypotension and bradycardia during greenlight laser transurethral resection of prostate: case report of two cases.
作者信息
Guan Zheng, Liu Jingjie
机构信息
Department of Anesthesiology, The First Affiliated Hospital of Xi'an Jiaotong University, Yanta West Road, No.277, 710061, Xi'an, China.
Department of Neurology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
出版信息
BMC Anesthesiol. 2016 Aug 30;16(1):70. doi: 10.1186/s12871-016-0234-x.
BACKGROUND
Greenlight laser transurethral resection of prostate (TURP) is a standard surgical method used to treat patients with prostate gland enlargement, it is safe and effective.
CASE PRESENTATION
We report two cases of sudden occurence of hypotension and bradycardia during greenlight laser TURP. Two patients with benign prostatic hypertrophy were scheduled for greenlight laser TURP under spinal anesthesia. Hypotension and bradycardia were suddenly occurred during the operation. The blood gas analysis revealed no hyponatremia (indicating TURP syndrome) or anemia (indicating hemorrhage). Operation was suspended and inotropic agents were administrated intravenous immediately, then blood pressure and heart rate increased to normal level within some minutes. The patients were discharged from hospital without any complications. We considered parasympathetic reflex was occurred during greenlight laser TURP.
CONCLUSION
Apart from TURP syndrome, hemorrhage, bladder perforation and high spinal anesthesia, the parasympathetic reflex which is caused by operative process can also induce hypotension and bradycardia during TURP.
背景
绿激光经尿道前列腺切除术（TURP）是治疗前列腺增生患者的标准手术方法，安全有效。
病例报告
我们报告两例绿激光TURP术中突然出现低血压和心动过缓的病例。两名良性前列腺增生患者计划在脊髓麻醉下进行绿激光TURP。术中突然出现低血压和心动过缓。血气分析显示无低钠血症（提示TURP综合征）或贫血（提示出血）。手术暂停，立即静脉注射血管活性药物，几分钟内血压和心率恢复正常水平。患者出院时无任何并发症。我们认为绿激光TURP术中发生了副交感神经反射。
结论
除TURP综合征、出血、膀胱穿孔和高位脊髓麻醉外，手术过程引起的副交感神经反射也可在TURP术中诱发低血压和心动过缓。
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