利多卡因乳膏减轻男性下尿路手术后尿管相关刺激症状的效果  

Evaluation of effect of compound lidocaine cream on alleviating catheter-related bladder discomfort inmale patients undergoing lower urinary tract surgeries

作　　者：张雪荣 杨雪莹[1] Zhang Xuerong;Yang Xueying(Department of Anesthesiology,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,广州510120

出　　处：《新医学》2020年第6期459-462,共4页Journal of New Medicine

摘　　要：目的探讨利多卡因乳膏能否减轻接受下尿路手术的男性患者术后尿管相关刺激症状(CRBD)。方法将择期于全身麻醉下接受下尿路手术、术后需留置20号或22号三腔尿管的男性患者80例随机分为乳膏组(40例)和对照组(40例)。乳膏组插尿管前于其前端涂抹利多卡因乳膏5 g再行导尿,对照组则行常规导尿。记录麻醉诱导前(T1)、手术结束时(T2)、喉罩拔出后5 min(T3)、30 min(T4)和2 h(T5)5个时间点的心率和平均血压。评估2组患者T3、T4、T5的CRBD发生率及其严重程度。结果乳膏组T3、T4的心率和平均血压均低于对照组(P均<0.05)。乳膏组T3、T4时中至重度CRBD的发生率低于对照组(P均<0.05)。结论全身麻醉下行下尿路手术后,对于需留置20号或22号三腔尿管的男性患者,利多卡因乳膏可降低其术后2 h内中至重度CRBD的发生率,且能使全身麻醉苏醒期的血流动力学更平稳。Objective To investigate whether compound lidocaine cream can relieve catheter-related bladder discomfort(CRBD)in male patients undergoing lower urinary tract surgeries.Methods Eighty adult male patients undergoing elective lower urinary tract surgeries and postoperative indwelling 20#or 22#threelumen urinary catheter under general anesthesia were randomly allocated into the cream(n=40)and control groups(n=40).Patients in the cream group were applied with 5 g compound lidocaine cream at the front of the catheter to assist catheterization,and those in the control group received routine catheterization.The heart rate and mean blood pressure were recorded before the induction of anesthesia(T1),at the end of surgery(T2),at 5 min(T3),30 min(T4)and 2 h(T5)after laryngeal mask removal.The incidence and severity of CRBD were assessed at 5 min,30 min and 2 h after laryngeal mask removal.Results At T3 and T4,the heart rate and mean blood pressure in the cream group were significantly lower than those in the control group(both P<0.05).At T3 and T4,the incidence of moderate to severe CRBD in the cream group was significantly lower compared with that in the control group(both P<0.05).Conclusions Urethral catheterization with compound lidocaine cream can reduce the incidence of moderate to severe CRBD within postoperative 2 h in male patients undergoing lower urinary tract surgeries and indwelling 20#or 22#three-lumen urinary catheter under general anesthesia,and stabilize the hemodynamics during the recovery period of general anesthesia.

关 键 词：尿管相关刺激症状 复方利多卡因乳膏 三腔尿管 下尿路手术 

分 类 号：R614.2[医药卫生—麻醉学]