耻骨后开放性前列腺根治术的麻醉：腰麻-硬膜外联合麻醉与全麻-硬膜外联合麻醉的比较

Anesthesia for Open Radical Retropubic Prostatectomy: A Comparison between Combined Spinal Epidural Anesthesia and Combined General Epidural Anesthesia.

作者信息

Kofler O, Prueckner S, Weninger E, Tomasi R, Karl A, Niedermayer S, Jovanovic A, Müller H H, Stief C, Zwissler B, von Dossow V

机构信息

Department of Anesthesiology, Ludwig-Maximilians-University of Munich, Munich, Germany.

Department of Anesthesiology, Ruprecht-Karls-University, Heidelberg, Germany.

出版信息

Prostate Cancer. 2019 May 14;2019:4921620. doi: 10.1155/2019/4921620. eCollection 2019.

DOI:10.1155/2019/4921620

PMID:31218084

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6536977/

Abstract

BACKGROUND

Several anesthesiologic regimens can be used for open radical retropubic prostatectomy. The aim of this retrospective analysis was to compare the combined general epidural anesthesia and the combined spinal epidural anesthesia with regard to availability, efficacy, side effects, and perioperative time consumption in a high-volume center.

METHODS

A retrospective analysis was performed by querying the electronic medical records of 1207 consecutive patients from the database of our online documentation software. All patients underwent open radical retropubic prostatectomy from 01/2008 to 08/2011 and met the study criteria. Linear and multivariate regression analyses were performed to identify differences in parameters such as time consumption in the operating unit, hemodynamic parameters, volume replacement, and catecholamine therapy.

RESULTS

698 (57.8%) patients have been undergoing open radical retropubic prostatectomy under combined spinal epidural anesthesia and 509 (42.2%) patients by combined general epidural anesthesia. Operating unit (p <0.0001) and post-anesthesia care unit stay (p <0.0001) as well as total hospital stay (p <0.0001) were significantly shorter in the combined spinal epidural anesthesia group. In addition, this group had reduced intraoperative volume need (p <0.0001) as well as lower need of catecholamines (p <0.0001).

CONCLUSIONS

This retrospective study suggests that the combined spinal epidural anesthesia seems to be a suitable and efficient anesthesia technique for patients undergoing open radical retropubic prostatectomy. This specific approach reduces time in the operation unit and length of hospital stay.

摘要

背景

几种麻醉方案可用于开放性耻骨后根治性前列腺切除术。本回顾性分析的目的是在一个高容量中心比较联合全身麻醉与硬膜外麻醉和联合腰麻与硬膜外麻醉在可用性、有效性、副作用及围手术期时间消耗方面的差异。

方法

通过查询我们在线文档软件数据库中1207例连续患者的电子病历进行回顾性分析。所有患者在2008年1月至2011年8月期间接受了开放性耻骨后根治性前列腺切除术且符合研究标准。进行线性和多变量回归分析以确定诸如手术单元时间消耗、血流动力学参数、容量补充和儿茶酚胺治疗等参数的差异。

结果

698例（57.8%）患者接受了联合腰麻与硬膜外麻醉下的开放性耻骨后根治性前列腺切除术，509例（42.2%）患者接受了联合全身麻醉与硬膜外麻醉。联合腰麻与硬膜外麻醉组的手术单元停留时间（p<0.0001）、麻醉后监护病房停留时间（p<0.0001）以及总住院时间（p<0.0001）均显著缩短。此外，该组术中容量需求减少（p<0.0001），儿茶酚胺需求也较低（p<0.0001）。