Frank E, Sood O P, Torjman M, Mulholland S G, Gomella L G
Department of Anesthesiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
J Surg Oncol. 1998 Feb;67(2):117-20. doi: 10.1002/(sici)1096-9098(199802)67:2<117::aid-jso8>3.0.co;2-d.
We retrospectively examined the effects of epidural analgesia on patients undergoing radical retropubic prostatectomy (RRP).
Patients (203) underwent radical retropubic prostatectomy under either general or epidural anesthesia alone or a combined general epidural technique. Of those, 143 had an epidural catheter placed and underwent radical retropubic prostatectomy under general anesthesia followed by postoperative epidural analgesia (Group E+G). Twenty-eight patients had the operation under epidural anesthesia followed by epidural analgesia in the postoperative period (Group E). Thirty-two patients had general anesthesia for the operation and postoperative systemic analgesia (Group G).
There were no significant differences between the groups with respect to age, height, weight, ASA status, or operation time. The length of postoperative hospital stay was significantly longer in the general anesthesia group patients as compared to the other two groups (P < 0.05). Intraoperative blood loss and blood replacement were significantly higher in the general anesthesia group (P < 0.001). There were no significant differences between the groups with respect to return of bowel function postoperatively, or incidence of complications.
Epidural anesthesia and analgesia following radical retropubic prostatectomy have demonstrated a number of beneficial effects. These include decreased blood loss and shorter hospital stay.
我们回顾性研究了硬膜外镇痛对耻骨后根治性前列腺切除术（RRP）患者的影响。
203例患者在单纯全身麻醉、单纯硬膜外麻醉或全身-硬膜外联合麻醉下接受耻骨后根治性前列腺切除术。其中，143例患者置入硬膜外导管，在全身麻醉下接受耻骨后根治性前列腺切除术，术后给予硬膜外镇痛（E+G组）。28例患者在硬膜外麻醉下手术，术后给予硬膜外镇痛（E组）。32例患者手术采用全身麻醉，术后给予全身镇痛（G组）。
三组患者在年龄、身高、体重、ASA分级或手术时间方面无显著差异。与其他两组相比，全身麻醉组患者术后住院时间显著延长（P<0.05）。全身麻醉组术中失血量和输血量显著更高（P<0.001）。三组患者术后肠功能恢复情况或并发症发生率无显著差异。
耻骨后根治性前列腺切除术后采用硬膜外麻醉和镇痛已显示出许多有益效果。这些效果包括减少失血量和缩短住院时间。
