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脊髓麻醉联合闭孔神经阻滞在经尿道膀胱肿瘤切除术中预防内收肌收缩的有效性。

Effectiveness of spinal anesthesia combined with obturator nerve blockade in preventing adductor muscle contraction during transurethral resection of bladder tumor.

作者信息

Alavi Cyrus Emir, Asgari Seyed Alaeddin, Falahatkar Siavash, Rimaz Siamak, Naghipour Mohammadreza, Khoshrang Hossein, Jafari Mehdi, Herfeh Nadia

机构信息

Anesthesiology Research Center, School of Medicine, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Urology Research Center, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

Turk J Urol. 2017 Dec;43(4):507-511. doi: 10.5152/tud.2017.96992. Epub 2017 Dec 1.

Abstract

OBJECTIVE

To determine whether spinal anesthesia combined with obturator nerve blockade (SOB) is effective in preventing obturator nerve stimulation, jerking and bladder perforation during transurethral resection of bladder tumor (TURBT).

MATERIAL AND METHODS

In this clinical trial, 30 patients were randomly divided into two groups: spinal anesthesia (SA) and SOB. In SA group, 2.5 cc of 0.5% bupivacaine was injected intrathecally using a 25-gauge spinal needle and in SOB after spinal anesthesia, a classic obturator nerve blockade was performed by using nerve stimulation technique.

RESULTS

There was a statistically significant difference between jerking in both groups (p=0.006). During the TURBT, surgeon satisfaction was significantly higher in SOB group compared to SA group (p=0.006). There was no significant correlation between sex, patient age and location of bladder tumor between the groups (p>0.05).

CONCLUSION

Obturator nerve blockade by using 15 cc lidocaine 1% is effective in preventing adductor muscle spasms during TURBT.

摘要

目的

确定脊髓麻醉联合闭孔神经阻滞(SOB)在经尿道膀胱肿瘤切除术(TURBT)期间预防闭孔神经刺激、抽搐和膀胱穿孔是否有效。

材料与方法

在这项临床试验中,30例患者被随机分为两组:脊髓麻醉(SA)组和SOB组。SA组使用25G脊髓穿刺针鞘内注射2.5cc 0.5%布比卡因,SOB组在脊髓麻醉后采用神经刺激技术进行经典的闭孔神经阻滞。

结果

两组抽搐情况存在统计学显著差异(p=0.006)。在TURBT期间,SOB组外科医生的满意度显著高于SA组(p=0.006)。两组之间的性别、患者年龄和膀胱肿瘤位置无显著相关性(p>0.05)。

结论

使用15cc 1%利多卡因进行闭孔神经阻滞可有效预防TURBT期间内收肌痉挛。

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