経会陰式前立腺生検における麻酔方法の検討 - 脊髄くも膜下麻酔(サドルブロック)と仙骨硬膜外麻酔の比較 -

Abstract

経会陰式前立腺生検における麻酔方法について, 脊髄くも膜下麻酔(サドルブロック)群59例と仙骨硬膜外麻酔群78例で疼痛, 合併症を比較検討した.各麻酔法の選択は無作為に行った.その結果, 麻酔時穿刺痛は2群で有意差を認めず, 生検時穿刺痛はサドルブロック群が有意に少なく, 殆どの例が痛みを全く感じていなかった.合併症はサドルブロック群で検査後尿閉が多く, 検査後安静時間は平均3.4時間を必要とした

We examined the anesthesia of transperineal prostate biopsy under saddle block or caudal block. Between July 2003 and September 2004, we performed transperineal prostate biopsy under saddle block and caudal block, in 59 and 78 patients, respectively. We evaluated the pain score with the FACES Pain Rating Scale (0-5) and examined side effects on each anesthesia. There was no significant difference in the pain score of anesthesia prick between saddle block and caudal block (1.51 +/- 1.03 versus 1.39 +/- 0.98 respectively, P = 0.629), but the biopsy prick under saddle block revealed significantly (P < 0.0001) lower pain score (0.05 +/- 0.22) than caudal block (1.18 +/- 1.22). Saddle block caused post-operative retention more frequently than caudal block and required the patient to rest in bed for several hours after prostate biopsy. Saddle block was useful for relieving the pain of biopsy. In future, we need to consider using a method with fewer side effects.