丁卡因胶浆复合依托咪酯在拔除双J管术中的应用效果  

Study on the Effect of Tetracaine Mucilage Combined with Etomidate in the Removal of Double-J Tube

作　　者：张龙 蒋晖 杨仪莹 邓利兵 杨传信 周海洲 沙勤 梁婧 ZHANG Long;JIANG Hui;YANG Yiying(Department of Anesthesiology,Qingpu Branch of Zhongshan Hospital,Fudan University,Shanghai 201700)

机构地区：[1]复旦大学附属中山医院青浦分院麻醉科,上海201700

出　　处：《医学临床研究》2023年第11期1620-1623,共4页Journal of Clinical Research

基　　金：上海市青浦区卫生健康委员会科研项目(编号:W2019-01)。

摘　　要：【目的】探讨丁卡因胶浆复合依托咪酯在拔除双J管术中的应用效果。【方法】行膀胱镜下双J管拔除术的180例患者,随机分为丁卡因胶浆组(A组)、丁卡因胶浆复合依托咪酯组(B组)、芬太尼复合依托咪酯组(C组),每组60例。比较三组患者摆好截石位(T_(0))、给药后2 min(T_(1))、进入膀胱后(T_(2))、拔出双J管后(T_(3))的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_(2))、呼吸频率(RR)和术中不良反应发生情况,手术时间以及术后尿道疼痛刺激[视觉模拟评分法(VAS)]评分。比较患者、手术医师及麻醉医师三方满意度。【结果】A组患者在T_(2)、T_(3)的MAP、RR、HR均高于B组和C组(P<0.05);C组患者在T_(1)的MAP、RR、SpO_(2)均低于A组和B组(P<0.05);A组术中体动发生率高于B组和C组,肌阵挛发生率低于B组和C组(均P<0.05);C组术中呼吸抑制、头晕、恶心、呕吐的发生率均高于A组和B组(P<0.05);A组患者的手术时间以及在术后10 min、1 h的VAS评分均高于B组和C组(P<0.05);B组在术后2 h的VAS评分低于A组和C组(P<0.05);B组患者、手术医师及麻醉医师三方满意度均高于A组和C组(P<0.05)。【结论】丁卡因胶浆复合依托咪酯在拔除双J管术中的效果较好,可在超短时间内镇痛、镇静,且不良反应少。【Objective】To investigate the effect of tetracaine mucilage combined with etomidate in the removal of double-J tube.【Methods】A total of 180 patients undergoing cystoscopy-assisted double-J tube removal were randomly divided into tetracaine mucilage group(group A),tetracaine mucilage combined with etomidate group(group B),and fentanyl combined with etomidate group(group C),with 60 cases in each group.The mean arterial pressure(MAP),heart rate(HR),pulse oximetry(SpO_(2)),respiratory rate(RR),and adverse reactions during the operation were compared at each time point of the patients'lithotomy position(T_(0)),2 minutes after administration(T_(1)),after entering the bladder(T_(2)),and after removing the double-J tube(T_(3)).The operation time and postoperative urethral pain stimulation[visual analog scale(VAS)]scores were also compared.The satisfaction of patients,operating physicians,and anesthesiologists was compared.【Results】The MAP,RR,and HR at T_(2) and T_(3) in group A were higher than those in group B and C(P<0.05);the MAP,RR,and SpO_(2) at T_(1) in group C were lower than those in group A and B(P<0.05);the incidence of body movement during the operation in group A was higher than that in group B and C,while the incidence of myoclonus was lower than that in group B and C(both P<0.05);the incidence of respiratory depression,dizziness,nausea,and vomiting in group C was higher than that in group A and B(P<0.05);the operation time and VAS scores at 10 minutes and 1 hour after surgery in group A were higher than those in group B and C(P<0.05);the VAS score at 2 hours after surgery in group B was lower than that in group A and C(P<0.05);the satisfaction of patients,operating physicians,and anesthesiologists in group B was higher than that in group A and C(P<0.05).【Conclosion】The effect of tetracaine mucilage combined with etomidate in the removal of double-J tube is better,with the advantages of short-term analgesia,sedation,and less adverse reactions.

关 键 词：丁卡因/治疗应用 依托咪酯/治疗应用 导管 留置 

分 类 号：R691.4[医药卫生—泌尿科学]