摘要: |
目的:比较前列腺周围神经阻滞麻醉(PPNB)及单纯尖部浸润麻醉在经会阴前列腺穿刺过程中的镇痛疗效及安全性。
方法:收集 2017 年 4 月至 2017 年 10 月于川北医学院附属医院行经会阴前列腺穿刺活检的80例患者,经直肠检查后采用利多卡因对两侧穿刺点随机给予前列腺单纯尖部浸润麻及PPNB及两种不同的局部麻醉方式,分别记为 A、 B组,记录两组麻醉、穿刺过程中及穿刺后患者不良反应,评价两种麻醉方式的安全性,术后试卷模拟量化表(VAS) 评分,评估两种麻醉方式对于疼痛的改善效果。
结果:在经会阴前列腺穿刺活检麻醉及穿刺过程中,未发生与麻醉相关的严重不良反应,两组操作前后患者头晕、心慌、胸闷、呼吸困难等症状差异无统计学差异(P≥0.05),麻醉过程中两组(VAS)评分比较差异无统计学意义(P≥0.05),穿刺过程中两组(VAS)评分比较差异有统计学意义(P<0.05)。
结论:前列腺周围神经阻滞麻醉在经会阴前列腺穿刺中是一种安全、有效的麻醉方法,镇痛效果较单纯尖部浸润麻醉效果好,值得临床推广应用。 |
关键词: 经会阴前列腺穿刺 麻醉 PPNB 镇痛疗效 安全性 |
DOI: |
投稿时间:2018-11-27修订日期:2018-12-04 |
基金项目: |
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Comparison of analgesic effects between infiltration anesthesia in local apical periprostate?and combined periprostatic nerve block in transperineal prostate biopsy |
hexiuli,yuewensheng |
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Abstract: |
Objective:To compare the analgesic efficiency?and?safety between local apical periprostate?infiltration anesthesia and combined periprostatic nerve block (PPNB) in transperineal prostate biopsy(TPPB).
Methods:80 patients who underwent transperineal prostate biopsy in the Ultrasonic Diagnosis Department of Affiliated Hospital of North Sichuan Medical College were enrolled in during April 2017 to October 2012. After transrectal ultrasound examination, assessing the prostatic diameter, prostate volume , transition zone, capsular and seminal vesicle characteristics, blood flow and the suspicious lesions etc. Two different?anesthesia?styles were randomly selected between left and right lobe prostate . The first group received local?Lidocaine anesthesia?onto the capsula of the apex (Group A), meanwhile,the second group received periprostatic nerve block (Group B) besides basal local apical periprostate?infiltration anesthesia . Intraoperative and postoperative adverse events as well as complications were recorded detailed to evaluate the safety of the two anesthesia methods. Pain evaluation during anaesthetic and biopsy was explained to the patients, and this assessment was performed using an 10-point linear visual analog scale(VAS).
Results:There were no serious adverse events associated with anesthesia during biopsy. The heart rate and blood pressure exhibited mild fluctuation during the operation and showed no significant difference between two groups (P>0.05). Meanwhile, there was no significant difference in VAS scores between two groups during anesthesia (P>0.05). A statistically significant difference was determined in terms of VAS between group A and B during biopsy(P<0.05), PPNB produced superior pain control than TPPB during sampling.
Conclusions:The PPNB is a safe and effective analgesic method during transperineal prostate biopsy, showing the better analgesic efficacy than local?anesthesia?onto the capsula of the apex, which is worthy of clinical application. |
Key words: Transperineal prostate biopsy anesthesia PPNB analgesic effect safety |