超声引导下罗哌卡因骶管阻滞对男性全身麻醉术后导尿管相关膀胱刺激征的影响  

Effect of Ultrasound-Guided Sacral Block with Ropivacaine on Catheter-Related Bladder Discomfort in Male Patients After General Anesthesia

作　　者：吴林举 凌勇[2] 邓纯勇[2] 周飞仁 涂发平[1] Wu Linju;Lin Yong;Deng Chunyong;Zhou Feiren;Tu Faping(Department of Anesthesiology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China;Department of Anesthesiology,The Third Hospital of Mianyang•Sichuan Mental Health Center,Mianyang 621000,China)

机构地区：[1]川北医学院附属医院麻醉科,南充637000 [2]绵阳市第三人民医院·四川省精神卫生中心麻醉科,绵阳621000

出　　处：《成都医学院学报》2024年第1期75-79,共5页Journal of Chengdu Medical College

基　　金：绵阳市卫生健康委员会2022年鼓励科研项目(No:202241)。

摘　　要：目的分析超声引导下不同浓度罗哌卡因骶管阻滞对男性全身麻醉患者术后导尿管相关膀胱刺激征(CRBD)的影响,探究罗哌卡因骶管阻滞对预防CRBD的适宜浓度。方法选取2021年6月至2023年6月在绵阳市第三人民医院进行经尿道输尿管软镜钬激光碎石取石术全身麻醉的129例患者为研究对象,采用随机数字表法分为试验组R1组(给予0.375%罗哌卡因骶管阻滞,n=43)、R2组(给予0.500%罗哌卡因骶管阻滞,n=43)和对照组C组(放置尿管前给予丁卡因胶浆尿道表面麻醉,n=43)。比较患者在麻醉复苏后0.5、2、4、6、12 h时CRBD发生率及严重程度、运动阻滞(Bromage)评分和视觉模拟疼痛(VAS)评分,并分析并发症发生情况。结果CRBD的发生率及严重程度R2组低于R1组和C组,R1组低于C组;患者复苏后0.5、2、4、6、12 h时,Bromage评分R1组低于R2组(P<0.05)。结论超声引导下,0.375%、0.500%罗哌卡因骶管阻滞均可以降低患者术中舒芬太尼的用量和麻醉苏醒后30 min时的CRBD发生率、严重程度,并减少术后CRBD相关不良事件的发生;0.375%罗哌卡因骶管阻滞的Bromage评分、VAS评分低,患者满意度更高。Objective To Analyze the effect of ultrasound-guided sacral block with different concentrations of ropivacaine on catheter-related bladder discomfort(CRBD)in male patients after general anesthesia,so as to explore the appropriate concentration of ropivacaine in ultrasound-guided sacral block for the prevention of CRBD.Methods A total of 129 patients who received general anesthesia for transurethral ureteroscopic holmium laser lithotripsy in the Third Hospital of Mianyang from June 2021 to June 2023 were selected as the study objects.They were divided into either experimental group[(group R1,sacral lock with 0.375%ropivacaine,n=43)or(group R2,sacral block with 0.500%ropivacaine,n=43)]or control group(group C,urethral surface anethesia with terracaine gel before urinary catheter placement,n=43)by random number table method.The incidence and severity of CRBD at 0.5,2,4,6 and 12 h after anesthesia recovery,Bromage score and Visual Analogue Scale(VAS)score were compared,and complications were analyzed.Results The incidence and severity of CRBD in group R2 were lower than those in group R1 and group C,and those in group R1 were lower than those in group C.At 0.5,2,4,6 and 12 h after anesthesia recovery,the Bromage score in group R1 were lower than that in group R2(P<0.05).Conclusion Ultrasound-guided sacral block with both 0.375%and 0.500%ropivacaine can reduce the dosage of sufentanil during surgery,the incidence and severity of CRBD at 30 minutes after anesthesia recovery,and the occurrence of postoperative CRBD related adverse events.And 0.375%ropivacaine for ultrasound-guided sacral block has lower Bromage score and VAS score,and higher patient satisfaction.

关 键 词：全身麻醉 罗哌卡因 骶管阻滞 导尿管相关膀胱刺激征 超声引导 

分 类 号：R614.42[医药卫生—麻醉学]