摘要
目的:探讨静脉输注利多卡因与右美托咪啶在全麻后留置尿管的男性患者导尿管源性膀胱不适(catheter-related bladder discomfort,CRBD)的临床效果。方法:选取本院行择期全麻手术的男性患者210例,随机分为利多卡因组(麻醉诱导时静滴利多卡因1.5 mg/kg,插管后持续静脉输注利多卡因2 mg·kg-1·h-1)、右美托咪啶组(麻醉诱导时采取10~15 min恒速泵注右美托咪啶0.5μg/kg,插管后持续静脉输注右美托咪啶0.4μg·kg-1·h-1)、对照组(麻醉诱导时静滴生理盐水,插管后持续静脉输注等量生理盐水)各70例,3组均采用16F的舒适导尿管经石蜡油润滑后置入膀胱,对比各组术中舒芬太尼用量、术后舒芬太尼用量以及拔管后不同时间点的CRBD评分、视觉模拟疼痛程度评分(VAS)、心率(HR)、收缩压(SBP)。结果:T1~T4时刻,利多卡因组CRBD评分均低于右美托咪啶组和对照组,利多卡因组的VAS评分均低于对照组,右美托咪啶组的CRBD评分、VAS评分均低于对照组,差异均具有统计学意义(P<0.05);在T0~T4时刻,各组HR、SBP比较,差异无统计学意义(P>0.05)。结论:利多卡因能减轻全麻后留置尿管男性患者CRBD的发生程度。
Objective: To investigate the clinical value of intravenous lidocaine in reducing CRBD in male patients who need catheterization after general anesthesia.Methods:A total of 210 male patients who underwent elective general anesthesia in our hospital from May 2017 to April 2018 were selected.Random number table method was used to divide the patients into the lidocaine group(1.5 mg/kg of intravenous lidocaine infusion during anesthesia induction,and continuous intravenous infusion of lidocaine 2 mg/kg/h after intubation),Dexmedetomidine group(0.5μg/kg of dexmedetomidine intravenously during anesthesia induction,continuous intravenous infusion of dexmedetomidine 0.4μg/kg/h after intubation)and control group(intravenous saline infusion during anesthesia induction,continuous intravenous infusion of the same amount of saline after intubation)with 70 cases in each group.All three groups were placed in the bladder with a 16F comfortable urethral catheter lubricated with paraffin oil.The amount of sufentanil used during the operation,the amount of sufentanil used after surgery,and the CRBD score and VAS at different time points after extubation were compared.Results:From T1 to T4,the CRBD scores of the lidocaine group were lower than those of the dexmedetomidine group and the control group(P<0.05).The VAS scores of the lidocaine group were lower than those of the control group(P<0.05),the CRBD score and VAS score of the dexmedetomidine group were lower than those of the control group(P<0.05);From T0 to T4,the differences in HR and SBP between the three groups were not statistically significant(P>0.05).Conclusion:Lidocaine administration in male patients requiring catheterization after general anesthesia can significantly reduce the incidence of CRBD.
作者
张帮健
杨小燕
薛强
沈娟
ZHANG Bang-jian;YANG Xiao-yan;XUE Qiang;SHEN Juan(Department of Anesthesiology, Panzhihua Central Hospital, Sichuan Province 617067 China)
出处
《海南医学院学报》
CAS
2020年第6期454-457,462,共5页
Journal of Hainan Medical University
基金
2018年攀枝花市市级科技计划项目和财政科技专项基金安排计划(2018CY-S-9)~~
关键词
全麻手术
导尿管
利多卡因
导尿管源性膀胱不适
General anesthesia
Catheter
Lidocaine
Catheter-induced bladder discomfort
作者简介
张帮健(1980-),四川攀枝花人,男,硕士研究生,副主任医师,电话:18096307256,E-mail:mst32589@163.com。
