右美托咪定联合达克罗宁胶浆镇痛对泌尿外科全麻病人术后导尿管相关性膀胱刺激征发生的影响  

Effect of dexmedetomidine combined with dyclocainemucilage analgesia on the incidence rate of postoperative catheter related bladder discomfort after general anesthesia

作　　者：王丽[1] 涂涛[1] 杨平亮 王辉[1] WANG Li;TU Tao;YANG Ping-liang;WANG Hui(Department of Anesthesiology,The First Affiliated Hospital of Chengdu Medical College,Chengdu Sichuan 610000,China)

机构地区：[1]成都医学院第一附属医院麻醉科,四川成都610000

出　　处：《蚌埠医学院学报》2022年第6期751-755,共5页Journal of Bengbu Medical College

基　　金：四川省教育厅科研项目(18ZA0158)。

摘　　要：目的:探讨右美托咪定联合达克罗宁胶浆镇痛对泌尿外科全麻病人术后导尿管相关性膀胱刺激征(CRBD)发生的影响。方法:选择行全麻手术的男性病人90例,根据随机数字表法分为右美托咪定组(D组)、右美托咪定联合达克罗宁胶浆(DD组)和对照组(C组),各30例。D组和DD组于麻醉诱导前静脉泵注1.0μg/kg右美托咪定,DD组在诱导后常规消毒外阴及尿道口,经尿道注入5 mL达克罗宁胶浆镇痛,并将2 mL达克罗宁胶浆均匀涂抹于导尿管上润滑,C组给予等量0.9%氯化钠溶液,行常规导尿术。观察并比较3组病人麻醉诱导前(T_(0))、拔管前(T_(1))、拔管时(T_(2))及拔管后15 min(T_(3))时刻的血流动力学指标变化、躁动评分(RS评分)、Ramsay镇静评分、麻醉恢复时间及术后CRBD发生率与程度。结果:与T_(0)时刻比较,C组T_(1)、T_(2)、T_(3)时刻收缩压(SBP)、舒张压(DBP)、心率(HR)均明显升高(P<0.05),D组T_(1)、T_(2)时刻SBP、DBP、HR明显升高(P<0.05),而DD组无明显变化(P>0.05);与C组比较,D组T_(2)、T_(3)时刻SBP、HR和T_(2)时刻DBP及DD组T_(1)、T_(2)、T_(3)时刻SBP、HR和T_(2)时刻DBP均较低(P<0.05),与D组比较,DD组T_(1)、T_(2)时刻SBP较低(P<0.05),其余比较差异均无统计学意义(P>0.05);与T_(0)时刻比较,D组、DD组T_(1)、T_(2)、T_(3)时刻RS评分、Ramsay镇静评分均明显降低(P<0.05),而C组无明显变化(P>0.05);与C组比较,D组及DD组各时间点RS评分均较低(P<0.05),Ramsay镇静评分较高(P<0.05);与D组比较,DD组各时间点RS评分差异均无统计学意义(P>0.05),Ramsay镇静评分除T_(0)时刻无统计学意义外,其他各时间点评分均较高(P<0.05)。3组呼吸恢复时间、苏醒时间及拔管时间比较差异均无统计学意义(P>0.05);与C组比较,D组及DD组术后CRBD发生率较低(P<0.01),CRBD程度较轻(P<0.01);与D组比较,DD组术后CRBD发生率较低(P<0.01),CRBD程度较轻(P<0.01)。结论:右美托咪定联合达克罗宁胶浆镇痛可有�Objective:To investigate the effects of dexmedetomidine combined with dyclonine mucilage analgesia on the incidence rate of postoperative catheter related bladder discomfort(CRBD)after general anesthesia.Methods:A total of 90 male patients with general anesthesia were divided into the dexmedetomidine group(group D),dexmedetomidine combined with dclonine mucilage(group DD)and control group(group C)according to the random number table method(30 cases each group).Before induction of anesthesia,the 1.0μg/kg dexmedetomidine was intravenously injected into the group D and group DD.After induction,the vulva and urethral orifice in the group DD were routinely disinfected,and the 5 mL dacronine glue was injected into the group DD through the urethra for analgesia,and 2 mL dacronine glue was evenly smeared on the urethra for lubrication.The group C were treated with equal amount of 0.9%sodium chloride solution for routine urethral catheterization.The changes of hemodynamic indexes,agitation score(RS score),Ramsay sedation score,anesthesia recovery time and incidence rate and degree of postoperative CRBD in three groups were observed and compared before anesthesia induction(T_(0)),before extubation(T_(1)),during extubation(T_(2))and after 15 min of extubation(T_(3)).Results:Compared with T_(0),the systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)in the group C at T_(1),T_(2) and T_(3) significantly increased(P<0.05),the SBP,DBP and HR in group D at T_(1) and T_(2) significantly increased(P<0.05),while there were not significant changes in the group DD(P>0.05).Compared with the group C,the SBP and HR at T_(2) and T_(3),and DBP at T_(2) in the group D were lower(P<0.05),and the SBP and HR at T_(1),T_(2) and T_(3),and DBP at T_(2) in the group DD were lower(P<0.05).Compared with the group D,the SBP in the group DD at T_(1) and T_(2) were lower(P<0.05),and there was no significant difference in the rest(P>0.05).Compared with the T_(0),the RS score and Ramsay sedation score in the group D and DD at T_

关 键 词：全身麻醉 导尿管相关性膀胱刺激征 右美托咪定 达克罗宁胶浆 

分 类 号：R614.2[医药卫生—麻醉学]