复方利多卡因乳膏在小儿隐匿性阴茎矫治术术后留置导尿管中的应用

目的观察复方利多卡因乳膏在儿童隐匿性阴茎矫治术后留置导尿管中的应用效果。方法选取行隐匿性阴茎矫治术患儿60例，采用随机数字表法分为观察组和对照组，各30例。观察组使用复方利多卡因乳膏润滑导尿管，对照组使用液体石蜡油润滑导尿管。记录2组患儿入室（T₀）、导尿后（T₁）、拔喉罩（T₂）、入麻醉后恢复室（T₃）以及定向力恢复（T₄）各时间点的平均动脉压（MAP）、心率（HR）；记录2组手术时间、麻醉时间、麻醉后恢复室停留时间；比较2组T₄时点Ramsay镇静评分、导尿管源性躁动评分，置导尿管一次性成功率及术后第1天尿常规情况。结果观察组患儿置导尿管一次性成功率为90.00%，与对照组的93.33%，差异无统计学意义（P>0.05）。观察组苏醒室停留时间短于对照组（P < 0.05）。2组患儿MAP、HR均随时间变化而变化，差异有统计学意义（P < 0.01）；在T₄时点，观察组MAP、HR均明显低于对照组（P < 0.01）。观察组患儿定向力恢复时Ramsay镇静评分明显高于对照组（P < 0.01），尿管源性躁动评分明显低于对照组（P < 0.01）；2组躁动发生率差异无统计学意义（P>0.05）。2组患儿术后第1天尿常规检查白细胞、红细胞和细菌数都在正常范围，差异无统计学意义（P>0.05）。结论复方利多卡因乳膏作为润滑剂用于儿童隐匿性阴茎矫治术术后留置导尿管，可减轻导尿管刺激引起的苏醒期躁动，降低应激反应。

Application of compound lidocaine cream in indwelling urethral catheter after buried penis surgery in children

ObjectiveTo observe the application effect of compound lidocaine cream in indwelling urethral catheter after buried penis surgery in children.MethodsSixty children with buried penis surgery were divided into the observation group and control group by random number table method, 30 cases in each group.The observation group used compound lidocaine cream to lubricate the catheter, and the control group used liquid paraffin oil to lubricate the catheter.The mean arterial pressure (MAP) and heart rate (HR) were recorded at the time point of before anesthesia induction (T₀), after catheterization (T₁), after laryngeal mask removal (T₂), after being transferred into recovery room (T₃) and after directional force recovery (T₄) in the two groups.The operation time, anesthesia time and stay time in recovery room were recorded.Ramsay sedation score and catheterization-induced agitation score at T₄, one-time success rate of catheterization and urine routine on the first day after operation were compared between the two groups.ResultsThe one-time success rate of catheterization in the observation group and control group was 90.00% and 93.33%, respectively, and the difference of which was not statistically significant (P>0.05).The stay time in observation group was shorter than that in control group (P < 0.05).MAP and HR in the two groups changed with time, and the difference of which was statistically significant (P < 0.01).At T₄, MAP and HR in observation group were significantly lower than those in control group (P < 0.01).Ramsay sedation score in observation group was significantly higher than that in control group(P < 0.01), and catheterization-induced agitation score was significantly lower than that in control group (P < 0.01).There was no significant difference in the incidence of agitation between the two groups (P>0.05).There was no significant difference in white blood cell, red blood cell and bacterial count between the two groups (P>0.05).ConclusionsCompound lidocaine cream as a lubricant for indwelling urethral catheter after buried penis surgery in children can reduce agitation caused by catheter stimulation and stress reaction.