双层面局部浸润麻醉下行经皮肾镜取石术治疗上尿路结石的麻醉效果

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Anesthetic effects of percutaneous nephrolithotomy for upper urinary calculi under two-plane local anesthesia

ZHAI Jianpo，ZHOU Ning，WANG Hai，LI Guizhong，MAN Libo

（Department of Urology，Beijing Jishuitan Hospital，Capital Medical University，Beijing 100096，China）

ABSTRACT：Objective To Compare the effectiveness of conventional local anesthesia （CLA） and two-plane local anesthesia （TPLA） in percutaneous nephrolithotomy （PCNL） so as to provide reference for clinical selection of appropriate anesthetic methods.Methods Clinical data of 345 patients with renal or ureteral calculi who underwent PCNL under local infiltration anesthesia in our hospital during Jan.2013 and Dec.2023 were retrospectively analyzed.The patients were divided into CLA group （n=114） and TPLA group （n=231） according to anesthetic methods.The intraoperative visual analogue scale （VAS） score，stone-free rate and incidence of complications were compared between the two groups.Results There were no significant differences in the baseline data between the two groups （P＞0.05）.When the cutaneous and renal channels were established，the VAS score was lower in the TPLA group than in the CLA group [（3.2±0.5） vs. （3.8±0.4），P=0.023].However，there was no significant difference in the VAS score during lithotripsy [（3.3±0.5） vs. （3.4±0.5），P=0.061].There were no significant differences between the two groups in terms of operation time，stone-free rate，hemoglobin drop，postoperative hospital stay，and time to remove nephrostomy tube and DJ tube retention time （P＞0.05）.Conclusion Both CLA and TPLA can provide good analgesia in PCNL，but TPLA can significantly reduce the pain sensation when the cutaneous and renal channels are established.

KEY WORDS：local infiltration anesthesia;two-plane local anesthesia；percutaneous nephrolithotomy;renal calculi;ureter calculi

摘要：目的 比较双层面局部浸润麻醉（TPLA）与传统局部浸润麻醉（CLA）在经皮肾镜取石术（PCNL）中的麻醉效果，为临床选择适宜麻醉方式提供参考。（剩余6707字）