老年经尿道前列腺电切除术患者的硬膜外麻醉管理探讨(1)
[摘要] 目的 探討老年经尿道前列腺电切除患者术中硬膜外麻醉管理的应用效果。 方法 选取2017年10月～2019年3月我院收治的行经尿道前列腺电切术治疗的88例患者为研究对象，所有患者均给予硬膜外麻醉管理，观察患者麻醉前、麻醉后5 min、10 min、30 min、手术结束患者的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)以及麻醉效果。 结果 术后麻醉效果达到完善75例(85.23%)，不完善9例(10.23%)，无效4例(4.54%)。术后因出血血压下降患者2例，补液和静脉注射麻黄碱治疗后缓解，术中呼吸急促患者2例，注射地塞米松后缓解。患者麻醉前、麻醉后5 min、10 min、30 min、手术结束患者的HR、MAP、SpO2比较，差异无统计学意义(P>0.05)。 结论 硬膜外麻醉管理应用于老年经尿道前列腺电切术患者中是安全有效的，对于患者心率、血压、血氧饱和度等血流动力学指标的影响较小，不会产生较大波动，值得在临床应用推广。
[关键词] 经尿道前列腺电切术;硬膜外麻醉管理;老年患者;应用效果
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2019)31-0103-04
Management of epidural anesthesia in elderly patients undergoing transurethral resection of prostate
WANG Weina1 HUANG Xiaojun1，2
1.Department of Anesthesiology， the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine， Hangzhou 310005， China; 2.The Second Clinical Medical College， Zhejiang University of Traditional Chinese Medicine， Hangzhou 310005， China
[Abstract] Objective To investigate the application effect of epidural anesthesia management in elderly patients undergoing transurethral resection of prostate. Methods 88 patients undergoing transurethral resection of the prostate were enrolled in our hospital from October 2017 to March 2019. All patients underwent epidural anesthesia management. The patient's heart rate(HR)， mean arterial pressure(MAP)， blood oxygen saturation(SpO2)values and anesthesia effect were observed before anesthesia and 5 minutes， 10 min， 30 min after anesthesia. Results There were 75 cases(85.23%)of postoperative anesthesia effect improvement， 9 cases(10.23%)of imperfect， and 4 cases of invalid(4.54%). In the postoperative period， 2 patients had decreased hemorrhagic blood pressure， and were relieved after rehydration and intravenous ephedrine treatment， and 2 patients had intraoperative shortness of breath， and were relieved after injection of dexamethasone. There were no significant differences in HR， MAP， and SpO2 between the patients before and after anesthesia， 5 min， 10 min， and 30 min after anesthesia(P>0.05). Conclusion Epidural anesthesia management is safe and effective in elderly patients undergoing transurethral resection of the prostate. It has little effect on hemodynamic parameters such as heart rate， blood pressure and oxygen saturation， and will not cause large fluctuations. Therefore it is worthy of application in clinical practice., 百拇医药(王维娜 黄晓军)
[关键词] 经尿道前列腺电切术;硬膜外麻醉管理;老年患者;应用效果
[中图分类号] R614 [文献标识码] B [文章编号] 1673-9701(2019)31-0103-04
Management of epidural anesthesia in elderly patients undergoing transurethral resection of prostate
WANG Weina1 HUANG Xiaojun1，2
1.Department of Anesthesiology， the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine， Hangzhou 310005， China; 2.The Second Clinical Medical College， Zhejiang University of Traditional Chinese Medicine， Hangzhou 310005， China
[Abstract] Objective To investigate the application effect of epidural anesthesia management in elderly patients undergoing transurethral resection of prostate. Methods 88 patients undergoing transurethral resection of the prostate were enrolled in our hospital from October 2017 to March 2019. All patients underwent epidural anesthesia management. The patient's heart rate(HR)， mean arterial pressure(MAP)， blood oxygen saturation(SpO2)values and anesthesia effect were observed before anesthesia and 5 minutes， 10 min， 30 min after anesthesia. Results There were 75 cases(85.23%)of postoperative anesthesia effect improvement， 9 cases(10.23%)of imperfect， and 4 cases of invalid(4.54%). In the postoperative period， 2 patients had decreased hemorrhagic blood pressure， and were relieved after rehydration and intravenous ephedrine treatment， and 2 patients had intraoperative shortness of breath， and were relieved after injection of dexamethasone. There were no significant differences in HR， MAP， and SpO2 between the patients before and after anesthesia， 5 min， 10 min， and 30 min after anesthesia(P>0.05). Conclusion Epidural anesthesia management is safe and effective in elderly patients undergoing transurethral resection of the prostate. It has little effect on hemodynamic parameters such as heart rate， blood pressure and oxygen saturation， and will not cause large fluctuations. Therefore it is worthy of application in clinical practice., 百拇医药(王维娜 黄晓军)