Shir Y, Frank S M, Brendler C B, Raja S N
Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Urology. 1994 Aug;44(2):232-6. doi: 10.1016/s0090-4295(94)80137-1.
To compare the effect of epidural and general anesthesia on the postoperative course and complication rate in patients undergoing radical prostatectomy.
Ninety-eight men scheduled for radical retropubic prostatectomy (RRP) were randomly assigned to receive epidural anesthesia only (EA, n = 34), combined epidural and general anesthesia (EG, n = 33) or general anesthesia only (GA, n = 31). In the EA group, epidural anesthesia was induced and maintained with bupivacaine. In the EG group, patients received epidural bupivacaine after the induction of general anesthesia. In the GA group, anesthesia was induced with morphine and maintained with isoflurane. In the postoperative period, epidural patient-controlled analgesia (PCA) was maintained in all patients for 3 to 5 days. Patients were evaluated throughout the hospitalization period and at 3, 6, and 12 weeks following surgery.
The three groups did not differ with regard to postoperative pain, bleeding, urine output, fever, length of paralytic ileus, or length of hospitalization. No major cardiovascular, pulmonary, or neurologic complications occurred in any of the patients either perioperatively or in the first 3 months postoperatively.
Intraoperative anesthetic technique was not associated with a different postoperative complication rate in patients undergoing RRP. The very low incidence of complications and the uniform postoperative analgesic regimen may have contributed to the similarity between groups.
比较硬膜外麻醉和全身麻醉对接受根治性前列腺切除术患者术后病程及并发症发生率的影响。
98例计划行耻骨后根治性前列腺切除术(RRP)的男性患者被随机分配,分别仅接受硬膜外麻醉(EA组,n = 34)、硬膜外与全身联合麻醉(EG组,n = 33)或仅接受全身麻醉(GA组,n = 31)。EA组采用布比卡因诱导并维持硬膜外麻醉。EG组在全身麻醉诱导后给予硬膜外布比卡因。GA组用吗啡诱导麻醉,异氟烷维持麻醉。术后,所有患者均接受硬膜外自控镇痛(PCA)3至5天。在整个住院期间以及术后3、6和12周对患者进行评估。
三组在术后疼痛、出血、尿量、发热、麻痹性肠梗阻持续时间或住院时间方面无差异。围手术期及术后前3个月,所有患者均未发生重大心血管、肺部或神经并发症。
RRP患者术中麻醉技术与术后并发症发生率的差异无关。并发症的低发生率和统一的术后镇痛方案可能是导致各组之间相似性的原因。