Different Postoperative Analgesia Strategy In Patients With Bladder Spasm After Transurethral Resection Of Prostate: A Randomized Controlled Study

Objective:The aim of this study was to investigate whether different postoperative analgesia methods were significantly different in relieving postoperative bladder spasm after transurethral resection of prostate.In order to reduce postoperative complications and adverse reactions,and to reduce the medical costs of patients and save medical resources.Method:A total of 80 elderly patients were randomly selected for elective transurethral resection of the prostate in our hospital.All the patients were classified as ASA I-?,aged 65-78 years.The score of simple Intelligence scale(MMSE)was not less than20 points.According to the random number table,It was divided into general anesthesia group(n =20)and intraspinal anesthesia group(n =60).According to the dosage of bupivacaine,intraspinal anesthesia group(n =20)was divided into group A(n =20,5mg),group B(n =20,7.5mg)and group C(n =20,10mg).Main observation of patients with venipuncture After pain or epidural analgesia,the incidence of bladder spasm was 24 hours after operation.The vital signs of patients undergoing general or intraspinal anesthesia,the onset time of anesthesia,the effect of anesthesia,the analgesic effect after operation,adverse reactions were recorded.Complications,anesthesia costs,hospital expenses,and length of stay.Result:(1)Postoperative intravenous analgesia was performed in the general anesthesia group.Postoperative bladder spasm occurred in 8 cases(40%).Epidural analgesia was performed in intraspinal anesthesia group,no postoperative bladder spasm occurred,and the incidence was 0%.There was significant difference between intravenous analgesia and epidural analgesia in relieving postoperative bladder spasm(P <0.05).(2)Anesthesia effect evaluation: intraspinal anesthesia A group,excellent 80%,good 20%,spinal anesthesia B group,excellent 90%,good 10%,spinal anesthesia C group,excellent 100%,spinal anesthesia three groups of anesthesia effect no significant difference P>0.05,no statistically significant.(3)Comparison of different bupivacaine dosages in the spinal canal: the onset time of sensory block in the three groups of patients in the spinal canal group,There was significant difference The onset time of motor block was significantly different between group B and group A(P<0.05),and there was a significant difference(P<0.05).was also significant difference in the maximum time of motor block between group B and group A(P <0.05).(4)The analgesic effect of postoperative intravenous analgesia in general anesthesia group was significantly different from that in intraspinal anesthesia group(P <0.05).(5)The incidence of hypotension,bradycardia and shivering in general anesthesia group was significantly different from that in intraspinal anesthesia group(P <0.05).The incidence of postoperative delirium and headache in general anesthesia group was not significantly different from that in intraspinal group(P >0.05).(6)The sum of hospitalization cost and anesthesia cost of intravenous analgesia in general anesthesia group and epidural analgesia in intraspinal anesthesia There was a significant difference between the groups(P<0.05).There was no significant difference in the number of days in hospital(P).>0.05).(7)There was no significant difference between general anesthesia group and intraspinal anesthesia group(P>0.05).such as preoperative MMSE score,intraoperative infusion volume,duration of operation,prostate quality and volume of bladder flushing fluid(P >0.05).At the same time,there was no significant difference in mean arterial pressure,heart rate and heart rate between general anesthesia group and spinal anesthesia group(P>0.05).blood oxygen saturation level in each monitoring period(P >0.05).Conclusion:1.If the patients undergoing transurethral resection of the prostate could use epidural analgesia,the bladder spasm after TURP could be alleviated more effectively than intravenous analgesia,thus reducing the cost of hospitalization and anesthesia.2.Although transurethral electroprostatectomy patients generally use intraspinal anesthesia,because it has the characteristics of quick onset,high success rate and low dose of local anesthetic,but in order to improve the comfort of patients and alleviate the pain caused by anesthesia,Patients with transurethral prostatectomy can also choose general anesthesia with tracheal intubation.