Salehi E
Z Urol Nephrol. 1978 Jun;71(6):397-408.
It is reported on the experiences of several years in 9,400 spinal anaesthesias in the urology in patients at an advanced age. Still at present the spinal anaesthesia has a dominating position in the urological intervention. Despite modern and differenciated anaesthetic methods the importance of the spinal anaesthesia is by no means reduced for most urological interventions, particularly for the transurethral operation technique, but it rather increased during the last years by the new local anaesthetics, by the development of thinnest spinal needles, but also the increased knowledge of the dangers of general anaesthesia. In urological diagnostics and therapy the spinal anaesthesia has still its full right and is less toxic for the patient and has less severe complications than the general anaesthesia. However, prerequisites for its use are: a) mastery of technique b) full assent of the patient c) psychic guidance of the patient during the whole duration of the intervention and d) balanced pre-, intra- and postoperative substitution of the volume e) overcoming of the established opinion that the spinal anaesthesia has a particular depressing effect on circulation and frequently causes post-spinal headache.
本文报道了在高龄泌尿外科患者中进行9400例脊髓麻醉的数年经验。目前,脊髓麻醉在泌尿外科手术中仍占据主导地位。尽管有现代且多样化的麻醉方法,但对于大多数泌尿外科手术,尤其是经尿道手术技术而言,脊髓麻醉的重要性丝毫未减,反而在过去几年中因新型局部麻醉剂、最细脊髓穿刺针的研发以及对全身麻醉风险认识的提高而有所增加。在泌尿外科诊断和治疗中,脊髓麻醉仍有其充分的合理性,对患者毒性较小,并发症也比全身麻醉少。然而,使用脊髓麻醉的前提条件是:a)掌握技术;b)患者完全同意;c)在整个手术过程中对患者进行心理引导;d)术前、术中和术后对血容量进行平衡补充;e)克服脊髓麻醉对循环有特殊抑制作用且常导致脊髓穿刺后头痛的既定观念。