Suppr超能文献

比较经尿道膀胱肿瘤电切术中不同闭孔神经阻滞方法:系统评价和网络荟萃分析。

Comparison of different methods of obturator nerve block in transurethral resection of bladder tumors: A systematic review and network meta-analysis.

机构信息

Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Cancer Med. 2023 Mar;12(5):5420-5435. doi: 10.1002/cam4.5364. Epub 2022 Nov 7.

Abstract

BACKGROUND

Bladder cancer is the most common malignancy of the urinary system, and accounts for 3% of newly diagnosed tumors. Transurethral resection of bladder tumor plays a key role in treating bladder cancer, among which one of the most serious complications is bladder perforation caused by obturator nerve reflex. Obturator nerve reflex can be prevented by inducing obturator nerve block after lumbar anesthesia. However, No study so far has compared the inhibitory effect of different obturator nerve block approaches on intraoperative obturator nerve reflex and bladder perforation.

METHOD

In this study, we conducted a network meta-analysis (NMA) of studies comparing the efficacy of different obturator nerve block approaches performed after lumbar anesthesia in operation.

RESULT

The distal obturator nerve block guided by peripheral nerve stimulator is the best approach for preventing obturator reflex. The proximal obturator nerve block guided by ultrasound is the best approach for preventing bladder perforation.

CONCLUSION

Spinal anesthesia combined with the distal obturator nerve block guided by peripheral nerve stimulator is the most optimal approach to prevent the obturator nerve reflex. But the doctor should choose the appropriate anesthesia method according to the patient's general condition, tumor location, and doctor's proficiency in puncture techniques.

摘要

背景

膀胱癌是泌尿系统最常见的恶性肿瘤,约占新诊断肿瘤的 3%。经尿道膀胱肿瘤切除术在膀胱癌的治疗中起着关键作用,其中最严重的并发症之一是闭孔神经反射引起的膀胱穿孔。腰麻后行闭孔神经阻滞可预防闭孔神经反射。然而,迄今为止尚无研究比较不同闭孔神经阻滞方法对术中闭孔神经反射和膀胱穿孔的抑制作用。

方法

本研究对腰麻后行不同闭孔神经阻滞方法的疗效进行了网络荟萃分析(NMA)。

结果

外周神经刺激器引导的闭孔神经远端阻滞是预防闭孔反射的最佳方法。超声引导的闭孔神经近端阻滞是预防膀胱穿孔的最佳方法。

结论

腰麻复合外周神经刺激器引导的闭孔神经远端阻滞是预防闭孔神经反射最理想的方法。但医生应根据患者的一般情况、肿瘤位置以及医生在穿刺技术方面的熟练程度选择合适的麻醉方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e09a/10028043/d2d3aeefe64f/CAM4-12-5420-g002.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验