Irani I, Bon D, Fournier F, Doré B, Aubert J
Department of Urology, La Milétrie, Centre Hospitalier Universitaire, Poitiers, France.
Br J Urol. 1996 Dec;78(6):904-6. doi: 10.1046/j.1464-410x.1996.24117.x.
To determine the acceptance by patients of transurethral incision of the prostate (TUIP) under local anaesthesia.
The study comprised 30 consecutive patients who elected to undergo local anaesthesia for TUIP and were treated between December 1994 and September 1995. Twenty-two were considered a high risk for general anaesthesia and eight patients chose local anaesthesia for personal reasons. Patients were premedicated (opioid and benzodiazepine) and 1% lidocaine was infiltrated transurethrally using an endoscopic needle. The level of acceptance was determined using an immediate post-operative questionnaire which included a linear visual analogue scale (VAS) to rate pain.
No patient required conversion to another type of anaesthesia and there were no complications related to the local anaesthesia. The mean (SE) VAS score was 3.2 (1.7) and the questionnaire results showed that 83% of the patients did not consider that general anaesthesia was necessary for the operation and that 90% would agree to undergo the procedure again under local anaesthesia.
TUIP under local anaesthesia was well tolerated in motivated patients. We recommend it as the operation of choice for the relief of obstruction in high-risk patients with a small benign prostatic hyperplasia.
确定患者对局部麻醉下经尿道前列腺切开术（TUIP）的接受程度。
本研究纳入了1994年12月至1995年9月期间连续30例选择接受TUIP局部麻醉治疗的患者。其中22例被认为全身麻醉风险高，8例因个人原因选择局部麻醉。患者术前使用了（阿片类药物和苯二氮䓬类药物）进行预处理，使用内镜针经尿道注入1%利多卡因。通过术后即时问卷调查确定接受程度，问卷包括线性视觉模拟量表（VAS）用于疼痛评分。
无患者需要转换为其他类型麻醉，且无与局部麻醉相关的并发症。VAS评分的均值（标准误）为3.2（1.7），问卷调查结果显示，83%的患者认为手术无需全身麻醉，90%的患者表示愿意再次接受局部麻醉下的该手术。
有意愿的患者对局部麻醉下的TUIP耐受性良好。我们推荐将其作为高危小体积良性前列腺增生患者梗阻解除手术的首选。
