布托菲诺联合盐酸丁卡因胶浆辅助导尿防治颌面整形术后导尿管源性膀胱不适

目的:观察布托菲诺联合盐酸丁卡因胶浆辅助导尿对全麻颌面整形术后男性患者导尿管源性膀胱不适(cather- related bladder discomfort,CRBD)的影响。方法:择期全麻颌面整形术男性患者90例,随机分为3组:传统导尿组( A 组)、盐酸丁卡因胶浆导尿组( B组)、布托菲诺联合盐酸丁卡因胶浆导尿组( C 组)。分别在手术结束拔除气管导管即刻(0 h)和拔管后1、2、3、6 h记录患者平均动脉压,心率以及手指血氧饱和度的改变;进行CRBD评分以及苏醒期躁动评分。结果:与A组相比,拔除气管导管即刻0 h和拔管后1 h,B、C两组CRBD评分以及苏醒期躁动评分均明显降低(P＜0.05);与 B 组相比,拔除气管导管即刻0 h和拔管后1 h,C组CRBD评分以及苏醒期躁动评分降低,血液动力学平稳,差异有统计学意义(P＜0.05),3组患者手指血氧饱和度均在96%以上,差异无统计学意义。结论:布托菲诺联合盐酸丁卡因胶浆辅助导尿有效减少全麻苏醒时和苏醒后1 h时CRBD症状的发生,明显减少苏醒期躁动。

Evaluation of Butorphanol Combined with Tetracaine Hydrochloride Jelly for the Prevention of Catheter-related Bladder Discomfort

Objective: To investigate the effects of butorphanol combined with Tetracaine Hydrochloride Jelly on catheter-related bladder discomfort. Methods: Ninety male patients undergoing selective maxillofacial plastic surgery were selected and divided into three groups. In group A, paraffin oil was used to daub the front end of catheter. In group B and group C, Tetracaine Hydrochloride Jelly was used to daub the front end of catheter. Meanwhile, in group C, butorphanol (20 μg/kg) was intravenously injected ten minutes before the end of operation. MAP, HR and SpO₂ were recorded at 0, 1, 2, 3, 6 hours after tracheal estuation. Agitation and urinary tract irritation in awakening period of patients were also recorded. Results: The incidence and scores of CRBD at 0h and 1h after tracheal extubation were significantly lower in group B than group A (P<0.05), and those indexes in group C was the lowest (P<0.05). Conclusion: Combination of butorphanol and Tetracaine Hydrochloride Jelly injected into the urethral of male patients during general anesthesia can reduce the CRBD at tracheal extubation immediately and 1 hour after tracheal extubation.