CN109745607A - A kind of method of the laryngeal mask sucking Sevoflurane lumbar anesthesia in resection of prostate - Google Patents
A kind of method of the laryngeal mask sucking Sevoflurane lumbar anesthesia in resection of prostate Download PDFInfo
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- CN109745607A CN109745607A CN201711084287.0A CN201711084287A CN109745607A CN 109745607 A CN109745607 A CN 109745607A CN 201711084287 A CN201711084287 A CN 201711084287A CN 109745607 A CN109745607 A CN 109745607A
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Abstract
Fasting 8h, a kind of laryngeal mask sucking Sevoflurane lumbar anesthesia prohibits drink 6h, atropine 0.5mg, sodium phenobarbital 0.1g, preoperative 30min intramuscular injection is routinely given after entering the room in the method for resection of prostate.It is punctured using 0.5% Bupivacaine 2.4ml (12mg) cavum subarachnoidale and selects laryngeal mask model further according to its weight after anaesthetizing, with 3-5 PLMA, mask starts to induce after inhaling pure oxygen 5min, the intravenous injection such as 1-2mg/kg Propofol, 0.2mg fentanyl, 100mg scoline, 1.5-2.5mg/kg atracurium, 0.05mg/kg Midazolam is carried out for patient, while connecting Drager Anesthesia machine and carrying out mechanical ventilation.Maintenance anesthesia is persistently pumped into art using 1-1.5mg/kg atracurium, 0.010-0.015mg/kg Remifentanil, 4-10mg/kg Propofol.Level of anesthesia is adjusted in T10 or less.Make irrigation of bladder liquid with 1.5% mannitol, perform the operation used time 25-120min.
Description
Technical field
The present invention relates to a kind of laryngeal masks to suck Sevoflurane lumbar anesthesia in the method for resection of prostate, specifically with a kind of larynx
Method of the cover sucking Sevoflurane lumbar anesthesia in resection of prostate.
Background technique
Currently known benign prostatic hyperplasis (BPH) is one of the common disease of male, frequently-occurring disease, which shows
Morbidity crowd and age are there are significant related, and disease incidence obviously increases with advancing age, and data shows 60 years old crowd
There is male more than half to have different degrees of hyperplasia of prostate, and may be up to 83% to the ratio after 80 years old.It is obvious for having
The benign prostatic hyperplasis of symptom, treatment means relatively common at present are transurethral resection of prostate, and exactly due to case
Mostly merge the gerontal patient of different degrees of cardiopulmonary disease, so the risk between perioperative can not be ignored.It how to be gerontal patient
The problem of safely and effectively anesthesia method is worth exploration is selected in electrocision.
Summary of the invention
Total 72 patients of this experiment of general information, I-II grades of ASA, the age 61.4 ± 4.8 years old, weight 65.5 ±
4.4 kilograms, all patients are preoperative to be diagnosed as BPH through the inspections such as touch and abdominal B-scan ultrasonography, and postoperative pathological further confirms.It is preoperative
Complication situation includes: high blood pressure 19；Coronary atherosclerotic heart disease 25；Diabetes B 16；Chronic resistance
Plug property pulmonary disease 14；Rheumatic heart disease 2.
Method in August, 2014 in June, -2016 total 78 patients that the court carries out prostatectomy carry out with
Machine grouping, is divided into A group (36), B group (36).Conventional subarachnoid anesthesia is carried out when to A group patients surgery, and B group is suffered from
The subarachnoid anesthesia of person's routine uses laryngeal mask sucking Sevoflurane to maintain anesthesia simultaneously.Simultaneously to their postoperative recovery time,
Situations such as Postoperative Agitation and pain, is recorded.
Conventional interview patient before anesthesia, fasting 8h, taboo drink 6h, routinely give atropic before all patients enter the room after entering the room
Product 0.5mg, sodium phenobarbital 0.1g, preoperative 30min intramuscular injection.Open venous access, while promoting circulation of blood pressure (BP), heart rate (HR), exhaling
Inhale frequency (RR), electrocardiogram (ECG), blood oxygen saturation (SPO2) monitoring.To A group patient, using 0.5% Bupivacaine 2.4ml
Laryngeal mask model, 4-5 PLMA for men, 3-4 for women are selected further according to its weight after the puncture anesthesia of (12mg) cavum subarachnoidale
Number PLMA.Mask starts to induce after inhaling pure oxygen 5min, carries out 1-2mg/kg Propofol, 0.2mg fentanyl, 100mg department for patient
The intravenous injection such as Kelin, 1.5-2.5mg/kg atracurium, 0.05mg/kg Midazolam, and induction tracheal intubation is carried out, simultaneously
It connects Drager Anesthesia machine and carries out mechanical ventilation.1-1.5mg/kg atracurium, the auspicious sweet smell of 0.010-0.015mg/kg are used in art
Too Buddhist nun, 4-10mg/kg Propofol are persistently pumped into maintenance anesthesia.0.5% Bupivacaine 2.4ml (12mg) conduct pair is applied alone in B group
According to；Two groups of patients adjust level of anesthesia in T10 or less.Patient takes lithotomy position in art, makees irrigation of bladder liquid with 1.5% mannitol,
Perform the operation used time 25-120min.
Observation index continuously monitors SBP, DBP, HR, SpO2, ECG observation anesthesia onset time, anesthesia block improves time, fiber crops
Liquor-saturated effect, complication and adverse reaction etc..Wherein SBP, DBP, SpO2 respectively before anesthesia (T1), anesthesia after 5min (T2), fiber crops
(T4) four periods observe and record data at the end of liquor-saturated preceding 30min (T3), operation.It is counted using SPSS13.0 statistical software
According to analysis, all continuous datas are indicated using standard deviation ± mean (χ ± s), and row t is examined；Enumeration data percentage table
Show, row chi-square criterion；P < 0.05 is that difference is statistically significant.
As a result；2 patient's anaesthetic effects think satisfied, and surgical procedure is smooth, but B group patient's anesthesia onset time is bright
Aobvious to be faster than A group, A group patient has 7 patients are postoperative obturator nerve reflection occur, and B group occurs without an example, and two group differences have system
Meter learns meaning (P < 0.01).In terms of postoperative pain, it is mostly mild pain that A group patient is postoperative, B group patient it is postoperative in-severe aches
Based on pain, for follow-up A group without special main complaint, analgesic effect is good in postoperative 24 hours；All patients of B group have in various degree
Feel that urethra has paresthesia and lower abdomen distending pain uncomfortable (table 2).And A group irrigation time is generally 6-22h, and B group generally requires 12-
72h, difference has conspicuousness between two groups.All patients left hospital in postoperative 3-7 days.
Goal of the invention: benign prostatic hyperplasis (BPH) is one of the common disease of male, frequently-occurring disease, which shows
Morbidity crowd and age are there are significant related, and disease incidence obviously increases with advancing age, and data shows 60 years old crowd
There is male more than half to have different degrees of hyperplasia of prostate, and may be up to 83% to the ratio after 80 years old.It is obvious for having
The benign prostatic hyperplasis of symptom, treatment means relatively common at present are transurethral resection of prostate, and exactly due to case
Mostly merge the gerontal patient of different degrees of cardiopulmonary disease, so the risk between perioperative can not be ignored.It how to be gerontal patient
The problem of safely and effectively anesthesia method is worth exploration is selected in electrocision, to during conventional subarachnoid anesthesia
The effect that the sucking of Sevoflurane laryngeal mask is used in combination carries out analysis comparison, and laryngeal mask is that be widely used in clinical one kind in recent years novel logical
Gas mode belongs to upper respiratory tract air-breather, between tracheal catheter and mask, but ventilatory effect and single-chamber trachea cannula
It is similar.It is small to air flue stimulation since laryngeal mask is not inserted into tracheae compared with trachea cannula, so stress reaction is slight, can effectively keep away
Exempt from the intense stimulus of trachea cannula and cause the adverse reactions such as the fluctuation of blood pressure of patient, increased heart rate, to the Airway damage of patient
It is small with hemodynamic effects；And its is simple and convenient, so can yet be regarded as one kind more using laryngeal mask for gerontal patient
Ideal ventilating mode.
Technical solution: conventional subarachnoid anesthesia is carried out when to A group patients surgery, under B group patient's routine arachnoid
Chamber anaesthetizes while maintaining anesthesia using laryngeal mask sucking Sevoflurane.Fasting 8h, taboo drink 6h, routinely give after entering the room before all patients enter the room
Atropine 0.5mg, sodium phenobarbital 0.1g, preoperative 30min intramuscular injection.Open venous access, while promoting circulation of blood pressure (BP), heart rate
(HR), respiratory rate (RR), electrocardiogram (ECG), blood oxygen saturation (SPO2) monitoring.To A group patient, using 0.5% Bupivacaine
Laryngeal mask model, 4-5 PLMA for men, women are selected further according to its weight after the puncture anesthesia of 2.4ml (12mg) cavum subarachnoidale
With 3-4 PLMA.Mask inhale pure oxygen 5min after start to induce, for patient carry out 1-2mg/kg Propofol, 0.2mg fentanyl,
The intravenous injection such as 100mg scoline, 1.5-2.5mg/kg atracurium, 0.05mg/kg Midazolam, and carry out induction tracheal and insert
Pipe, while connecting Drager Anesthesia machine and carrying out mechanical ventilation.1-1.5mg/kg atracurium, 0.010-0.015mg/ are used in art
Kg Remifentanil, 4-10mg/kg Propofol are persistently pumped into maintenance anesthesia.0.5% Bupivacaine 2.4ml (12mg) is applied alone in B group
As control；Two groups of patients adjust level of anesthesia in T10 or less.Patient takes lithotomy position in art, makees bladder with 1.5% mannitol
Perfusion liquid, perform the operation used time 25-120min.
Invention a kind of is more managed so can yet be regarded as gerontal patient using laryngeal mask the utility model has the advantages that its is simple and convenient
The ventilating mode thought.
Preferred forms: drug therapy is used.
Claims (3)
1. fasting 8h, a kind of laryngeal mask sucking Sevoflurane lumbar anesthesia prohibits drink 6h, atropic is routinely given after entering the room in the method for resection of prostate
Product 0.5mg, sodium phenobarbital 0.1g, preoperative 30min intramuscular injection；It is worn using 0.5% Bupivacaine 2.4ml (12mg) cavum subarachnoidale
Laryngeal mask model is selected further according to its weight after thorn anesthesia, it is patient that with 3-5 PLMA, mask starts to induce after inhaling pure oxygen 5min
Carry out 1-2mg/kg Propofol, 0.2mg fentanyl, 100mg scoline, 1.5-2.5mg/kg atracurium, 0.05mg/kg imidazoles
It is stable to wait intravenous injection, while connecting Drager Anesthesia machine and carrying out mechanical ventilation；In art using 1-1.5mg/kg atracurium,
0.010-0.015mg/kg Remifentanil, 4-10mg/kg Propofol are persistently pumped into maintenance anesthesia；Level of anesthesia is adjusted to exist
T10 or less；Make irrigation of bladder liquid with 1.5% mannitol, perform the operation used time 25-120min.
2. according to the method described in claim 1, it is characterized in that: using 0.5% Bupivacaine 2.4ml (12mg) cavum subarachnoidale
It punctures and selects laryngeal mask model further according to its weight after anaesthetizing, with 3-5 PLMA, mask starts to induce after inhaling pure oxygen 5min, to suffer from
Person carries out 1-2mg/kg Propofol, 0.2mg fentanyl, 100mg scoline, 1.5-2.5mg/kg atracurium, 0.05mg/kg miaow
Azoles is stable to wait intravenous injection, while connecting Drager Anesthesia machine and carrying out mechanical ventilation；In art using 1-1.5mg/kg atracurium,
0.010-0.015mg/kg Remifentanil, 4-10mg/kg Propofol are persistently pumped into maintenance anesthesia；Level of anesthesia is adjusted to exist
T10 or less；Make irrigation of bladder liquid with 1.5% mannitol, perform the operation used time 25-120min.
3. according to the method described in claim 1, it is characterized in that: connecting Drager Anesthesia machine simultaneously carries out mechanical ventilation；In art
Dimension is persistently pumped into using 1-1.5mg/kg atracurium, 0.010-0.015mg/kg Remifentanil, 4-10mg/kg Propofol
Hold anesthesia；Level of anesthesia is adjusted in T10 or less；Make irrigation of bladder liquid with 1.5% mannitol, perform the operation used time 25-120min.
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Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2021141963A1 (en) * | 2020-01-10 | 2021-07-15 | Pacira Pharmaceuticals, Inc. | Treatment of pain by subarachnoid administration of sustained-release liposomal anesthetic compositions |
| US11813357B2 (en) | 2021-01-11 | 2023-11-14 | Pacira Pharmaceuticals, Inc. | Treatment of hip pain with sustained-release liposomal anesthetic compositions |
| US11819572B2 (en) | 2020-01-10 | 2023-11-21 | Pacira Pharmaceuticals, Inc. | Treatment of pain by administration of sustained-release liposomal anesthetic compositions |
| US11918565B1 (en) | 2022-11-03 | 2024-03-05 | Pacira Pharmaceuticals, Inc. | Treatment of post-operative pain via sciatic nerve block with sustained-release liposomal anesthetic compositions |
| US11931459B2 (en) | 2021-03-19 | 2024-03-19 | Pacira Pharmaceuticals, Inc. | Treatment of pain in pediatric patients by administration of sustained-release liposomal anesthetic compositions |
-
2017
- 2017-11-07 CN CN201711084287.0A patent/CN109745607A/en active Pending
Cited By (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2021141963A1 (en) * | 2020-01-10 | 2021-07-15 | Pacira Pharmaceuticals, Inc. | Treatment of pain by subarachnoid administration of sustained-release liposomal anesthetic compositions |
| US11759459B2 (en) | 2020-01-10 | 2023-09-19 | Pacira Pharmaceuticals, Inc. | Treatment of pain by subarachnoid administration of sustained-release liposomal anesthetic compositions |
| US11819572B2 (en) | 2020-01-10 | 2023-11-21 | Pacira Pharmaceuticals, Inc. | Treatment of pain by administration of sustained-release liposomal anesthetic compositions |
| US11813357B2 (en) | 2021-01-11 | 2023-11-14 | Pacira Pharmaceuticals, Inc. | Treatment of hip pain with sustained-release liposomal anesthetic compositions |
| US11819573B2 (en) | 2021-01-11 | 2023-11-21 | Pacira Pharmaceuticals, Inc. | Treatment of hip pain with sustained-release liposomal anesthetic compositions |
| US11918688B2 (en) | 2021-01-11 | 2024-03-05 | Pacira Pharmaceuticals, Inc. | Treatment of hip pain with sustained-release liposomal anesthetic compositions |
| US11931459B2 (en) | 2021-03-19 | 2024-03-19 | Pacira Pharmaceuticals, Inc. | Treatment of pain in pediatric patients by administration of sustained-release liposomal anesthetic compositions |
| US11918565B1 (en) | 2022-11-03 | 2024-03-05 | Pacira Pharmaceuticals, Inc. | Treatment of post-operative pain via sciatic nerve block with sustained-release liposomal anesthetic compositions |
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Application publication date: 20190514 |