Olgun Keleş Bilge, Tekir Yılmaz Elvan, Altınbaş Ali
Anesthesiology and Reanimation Department, Giresun University Faculty of Medicine, 28100 Giresun, Turkey.
J Clin Med. 2024 Jun 20;13(12):3617. doi: 10.3390/jcm13123617.
Catheter-related bladder discomfort (CRBD) due to indwelling urinary catheterization in patients undergoing transurethral resection of the prostate (TURP) is difficult to tolerate and needs to be treated. This randomized prospective study aimed to compare the efficacy of sacral erector spinae plane block (SESPB) and pudendal nerve block (PNB) in reducing the incidence and score of CRBD. This study was conducted between November and December 2023. ASA I-III, fifty-four TURP patients were divided into two groups: Group 1 received SESPB (n = 27) and Group 2 received PNB (n = 27) under ultrasound guidance at the end of surgery. The incidence of CRBD, CRBD score, numerical rating scale (NRS) score, use of rescue analgesics, block performance time, first call for analgesics, patient satisfaction, and side effects were recorded for 24 h. The incidence of CRBD was lowest at 33.3% and highest at 48.1% in Group 1 and lowest at 25.9% and highest at 48.1% in Group 2, with no significant difference between the groups at all measurement times. CRBD scores and NRS scores were low and similar between the two groups. Block performance times were 9 ± 1.7 min in SESPB and 20 ± 2.5 min in PNB, and there was a significant difference between the mean times ( < 0.001). Patient satisfaction was adequate and similar in both groups. SESPB demonstrated a similar decreasing effect to PNB on the incidence and scores of CRBD in the first 24 h following TURP operations. The duration of SESPB administration was shorter than PNB.
经尿道前列腺切除术（TURP）患者因留置导尿管导致的导管相关性膀胱不适（CRBD）难以耐受，需要进行治疗。这项随机前瞻性研究旨在比较骶棘肌平面阻滞（SESPB）和阴部神经阻滞（PNB）在降低CRBD发生率和评分方面的疗效。本研究于2023年11月至12月进行。将54例ASA I-III级的TURP患者分为两组：第1组在手术结束时于超声引导下接受SESPB（n = 27），第2组接受PNB（n = 27）。记录24小时内的CRBD发生率、CRBD评分、数字评分量表（NRS）评分、急救镇痛药的使用情况、阻滞操作时间、首次要求使用镇痛药的时间、患者满意度和副作用。第1组CRBD发生率最低为33.3%，最高为48.1%；第2组最低为25.9%，最高为48.1%，在所有测量时间点两组之间均无显著差异。两组的CRBD评分和NRS评分均较低且相似。SESPB的阻滞操作时间为9±1.7分钟，PNB为20±2.5分钟，平均时间之间存在显著差异（<0.001）。两组患者的满意度均较高且相似。在TURP手术后的前24小时内，SESPB在降低CRBD发生率和评分方面显示出与PNB相似的效果。SESPB的给药持续时间比PNB短。
