直肠用药减轻全麻后导尿管刺激的研究

Investigation on rectal administration for alleviating the stimulation of urinary catheter after general anesthesia

目的探讨直肠用药减轻全麻导尿患者清醒后尿管刺激的作用。方法将90例全麻后留置尿管的手术患者随机分为三组各30例。对照组全麻后常规导尿,实验Ⅰ组、实验Ⅱ组分别于全麻导尿后5min在直肠置入美施康定10mg和吲哚美辛100mg。观察三组手术不同时间段的HR、SBP、DBP、SpO2的变化和术后48h内尿管刺激对患者舒适度的影响。结果三组不同时段HR、SBP、DBP、SpO2比较,干预主效应均P>0.05;三组术后48h留置尿管期间舒适度比较,差异有统计学意义(P<0.01),且实验Ⅰ组优于实验Ⅱ组。结论全麻导尿后通过直肠给予镇痛剂可缓解麻醉清醒后患者对尿管刺激的不耐受,且不影响手术患者生命体征的稳定;直肠给予美施康定作用优于吲哚美辛。

Objective To probe into the effect of rectal administration for alleviating stimulation of urinary catheter in patients awakend from general anesthesia. Method A total of 90 patients were recruited into the study and were randomized into a control group, group I and group II, with each group having 30 cases. After general anesthesia, patients in the control group received urinary catheterization routinely, while patients in group Ⅰ and group Ⅱwere rectally administered with 10 mg of MS eontin and 100 mg of indomethacin respectively 5 min after catheterization. Such parameters as patients＇ heart rate （HR）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, and pulse oximetry （SpO2） were observed during the surgery, and degree of comfort 48 h after the surgery was also noted. Results There were no significant differences in the values of HR, SBP, DBP and SpO2 at different time point among the 3 groups （P〉0.05 for all）. But 48 h after the surgery, when all the patients were still catheterized, the degree of comfort had significant differences among the 3 groups （P〈0.01）, and group Ⅰ expressed more comfort than group Ⅱ. Conclusion Urinary catheterization after general anesthesia and rectal administration of analgesics not only reduces stimulation induced by catheterization and increases the level of comfort, and also stabilizes patients＇ vital signs. The effects of MS contin is better than indomethacin.