ABSTRACT
Objective To investigate the optimum dose of dezocine combined with ropivacaine for elderly patient -controlled epidural analgesia(PCEA)after transurethal resection of prostate (TURP)surgery.Methods Totally 90 elderly patients underwent TURP surgery with ASAⅡ-Ⅲ were randomly divided into three groups,30 cases in each group.For postoperative epidural analgesia,they were treated with different mixed liquor as following:group F:fentanyl 0.3mg +1.192% ropivacaine 20mL +normal saline to 100mL,group D1:dezocine 5mg +1.192% ropiva-caine 20mL +normal saline to 100mL,group D2:dezocine 7.5mg +1.192% ropivacaine 20mL +normal saline to 100mL.VAS and Bruggrmann Comfort Scale(BCS)and sedation score at 4,8,12,24,36,48h and side -effects,sleep quality score and general satisfaction score at 24,48h after operation were recorded.The ratio of best analgesia was evaluated.Results VAS of 4,8,12,24,36,48h after operation had no significant differences among three groups (F =1.65,1.72,1.75,1.73,1.58,1.63,all P >0.05).BCS of all points had no significant differences among three groups(F =1.48,1.51,1.44,1.38,1.38,1.38,all P >0.05).Sedation score of all time points had no significant differences among three groups(F =1.55,1.60,1.61,1.00,1.00,1.00,all P >0.05).Sleep quality score of 24,48h after operation had no significant differences among three groups(F =1.76,1.84,all P >0.05).General satisfaction score of 24,48h after operation had no significant differences among three groups(F =1.73,1.72,all P >0.05).The excellent and good rates of analgesia in three groups were 90.0%,93.3% and 93.3% respectively,and there were no significant difference (χ2 =0.873,0.873,all P >0.05).Compared with group F and group D1,the incidence rates of nausea and vomit were significantly increased in group D2(χ2 =4.25,4.32,all P <0.05),and the incidence rates of dizziness were significantly increased in group D2 (χ2 =4.36,4.08,all P <0.05 ),and the incidence rates of drowsiness was significantly increased in group D2(χ2 =7.85,7.85,all P <0.05).There were no pruritus and respir-atory depression in three groups.Conclusion The optimum dose of dezocine combined with ropivacaine for elderly PCEA after TURP surgery is 5mg.It can provide adequate pain relief and higher satisfaction with less side -effects.
ABSTRACT
Objective To compare the surgical effects of transurethal enucleation of prostate (TUEP)with transurethal resection of prostate (TURP) by a retrospective analysis of clinical data.Methods The patients in this study were divided into the groups of TUEP (enrolled in 2010 and 2011,n =77) and TURP (enrolled in 2009,n =27) with prostate larger than 60 g and smaller than 60 g respectively.Comparisons were made between the two groups in operation time,blood loss volume and weight of resected prostate.Results In the group of patients with prostate larger than 60 g,there was no significant difference in prostate weight ((88.5 ± 9.2) g vs.(107.0 ± 15.30) g,P =0.255),operation time ((91.5 ± 8.8) min vs.(118.3 ± 20.2)min,P =0.083),and weight of resected prostate ((48.0 ± 4.6) g vs.(58.4 ± 5.4) g,P =0.32) between the TUEP (53 patients) and the TURP (12 patients) groups.There was significant difference in blood loss ((110.0 ± 16.4) ml vs.(193.3 ± 22.3) ml,P =0.011) between the two groups.In the group of patients with prostate smaller than 60 g,there was no significant difference in prostate weight ((43.1 ± 3.2) g vs.(36.8 ± 3.4) g,P =0.072),operation time ((62.7 ±6.8) min vs.(69.3 ±6.2) min,P =0.431),blood loss ((56 ± 5) ml vs.(110±20) ml,P=0.082),and weight of resected prostate ((26.3 ±2.4) g vs.(23.6 ±2.1) g,P =0.291) between the TUEP (24 patients) and the TURP (15 patients) groups.Conclusion Compared with TURP,TUEP has the advantages of less blood loss in the treatment of patients with prostate larger than 60 g.With the improvement of surgeon' s experience and development of operation techniques,TURP will be replaced by TUEP.In the treatment of patients with prostate smaller than 60 g,the operation modality can be chosen by the surgeon based on his experience and proficiency.
ABSTRACT
Objective To explore the clinical efficacy of transurethral vaporization combined with resection in the treatment of benign prostatic hyperplasia(BPH) and prevention of complications. Methods Under low position continuous epidural anesthesia, 83 cases of BPH were treated by transurethral vaporization and resection with Stabilized loop, roller-shape and spade electrodes. Results The mean operative time was 58 min and blood loss 80ml. No blood transfusion was required and no transurethral resection syndrome(TURS) occurred. All patients had been followed up for 2 months～2 years. IPSS decreased from(26 4?5 7)points to(8 4?3 9) points( t =20 31, P