경요도 방광절제술을 위한 척추마취 후 지속적인 발기를 지닌환자의 마취관리 = Anesthetic Management of the Patient with Persistent Penile Erection Developed after Spinal Anesthesia

다국어 초록 (Multilingual Abstract)

A 50-year-old man with bladder cancer had spinal anesthesia for transurethral resection of bladder. After he had spinal block at the T8 level, he developed a persistent penile erection, making it impossible to introduce the 24 French cystoscope. To treat a persistent penile erection, intravenous glycopyrrolate was incrementally given for a total of 0.4 mg. A persistent penile erection was markedly subsided 5 minutes after last 0.2 mg glycopyrrolate was given. Then corpus cavernosum blood was aspirated. The cystoscope was easily introduced, and transurethral resection of bladder proceeded without further complication. (Korean J Anesthesiol 2004; 47: 446～8)

국문 초록 (Abstract)

지속발기증(priapism)은 성적인 흥분이 없는데도 발기가 지속되는 것으로 부위마취나 전신마취 후 아주 드물게 나타나고, 비뇨기과 수술을 시행 받는 환자의 1% 이하에서 발생한다고 보고되고 있다.1) 그리고 지속성 음경발기를 보이는 경우 수술을 연기하거나 취소시켜야 하는 경우도 있다. 마취 후 발생하는 발기에 대한 기전은 아직 정확히 밝혀져 있지 않고 다양한 약물과 수술이 치료에 사용되고 있다.
본 증례는 방광암을 지닌 환자에서 경요도 방광절제술을 위해 척추마취를 시행한 후 지속적인 음경발기로 방광경이 삽입이 되지 않아 glycopyrrolate 정주와 음경해면체(corpus cavernosum penis) 혈액흡인을 시행하여 발기를 완화시킨 경우로 척추마취 후 생긴 음경발기에 대해 문헌고찰과 함께 보고하는 바이다.

참고문헌 (Reference)

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