不同局部麻醉药在全身麻醉患者留置导尿管中的应用  

Reducing urethra irritation from indwelling catheter using different local anesthetic in patients during general anesthesia

作　　者：姚纹纹 张骐 崔雯 方明星 王玉龙 李成[2] 

机构地区：[1]芜湖市第二人民医院麻醉科,安徽芜湖241001 [2]皖南医学院麻醉学院,安徽芜湖241002

出　　处：《皖南医学院学报》2016年第3期286-288,共3页Journal of Wannan Medical College

摘　　要：目的：探讨不同局部麻醉药在全身麻醉患者留置导尿管中应用效果。方法：选择我院2014年3~12月胃肠外科全身麻醉下行下腹部手术的男性患者120例,实验组为复方利多卡因乳膏（L组）,达克罗宁胶浆（D组）辅助下行导尿术;对照组为石蜡油（S组）辅助下行导尿术,每组40人,分别记录入手术室时（T0）、导尿即刻（T1）、待意识恢复拔除气管导管时（T2）、术后24 h（T3）四个时间点患者的HR、MAP;T1、T2、T3三个时间点询问记录患者留置导尿管的尿道刺激症状疼痛的VAS评分和T3时间点记录患者留置导尿管的耐受程度。结果：与S组比较,L组和D组在T2、T3时间点的HR、MAP较低（P〈0.05）。与S组比较,L组和D组在T2、T3时间点的尿道刺激症状疼痛的VAS评分较低（P〈0.05）;与D组比较,L组在T3时间点的尿道刺激症状疼痛的VAS评分较低（P〈0.05）。与S、D组比较,L组在T3时间点的留置导尿管的耐受程度0级和Ⅰ级的发生率明显增高（P〈0.05）。结论：复方利多卡因乳膏和达克罗宁胶浆可以改善男性患者导尿管所致的HR增快、MAP增高和尿道刺激症状的疼痛,且复方利多卡因乳膏可提高术后留置导尿管时的耐受程度。Objective： To observe the effects of using different local anesthetic to reduce the urethra irritation from indwelling catheter in patients undergoing general anesthesia. Methods： 120 male patients undergoing elective abdominal surgery under general anesthesia were included from March to December of 2014,and randomized into 3 group L,D and S（ n = 40 for each）. Group L（ experimental group） received catheter à demeure with compound lidocaine cream,group D were given dyclonine latex and group S（ control group） liquid paraffin to assist the catheterization. The data were kept on heart rate（ HR）and mean arterial pressure（ MAP） at T0（ entry into the theater）,T1（ instant at catheterization）,T2（ tracheal extubation upon recovery of consciousness）and T3（ in 24 h after operation）. VAS score for urethra irritation was recorded at T1- T3,and tolerance to the catheterization was kept at T3. Results：Group L and D had lower HR and MAP as well as lower VAS scoring for urethra irritation at T2 and T3（ P〈0. 05）. Group L had lower VAS scores for urethra irritation than group D at T3（ P〈0. 05）,yet had higher incidence of catheter irritation at T3 than group S and D as tolerance by class 0- 1（ P〈0. 05）. Conclusion： Compound lidocaine cream and dyclonine latex can improve the HR,MAP and pain caused by indwelling catheter,and compound lidocaine cream may lead to increased tolerance to catheterization after operation.

关 键 词：复方利多卡因乳膏 达克罗宁胶浆 尿道刺激症状 全身麻醉 

分 类 号：R614.2[医药卫生—麻醉学] R472[医药卫生—外科学]