利多卡因乳膏预处理对导尿患者全麻恢复期尿路疼痛的影响

目的观察刺激预适应和利多卡因乳膏预处理对导尿患者全麻苏醒期尿路疼痛的影响。方法选择择期行胸科手术的男性患者90例,随机分成三组。观察组1于麻醉前常规安置尿管;观察组2于麻醉诱导前用利多卡因乳膏涂抹于尿管表面后导尿;观察组3于麻醉诱导后用利多卡因乳膏涂抹于尿管表面后导尿。记录患者苏醒时(T0)、苏醒后10min(T1)、20min(T2)及30min(T3)时平均动脉压、心率、切口舒适度评分及尿路疼痛的躁动评分。结果观察组1和观察组3在T1、T2及T3时血压和心率较苏醒时T0明显升高(P<0.001)。同一时点观察组1和观察组3的血压和心率较观察组2明显升高(P<0.001)。三组患者切口舒适程度在不同时点满意度均比较高,组内组间比较无明显差异(P>0.05);T1、T2及T3时观察组2满意率较观察组1和观察组3高(P<0.005)。结论刺激预适应和利多卡因乳膏预处理可有效降低因尿路疼痛引起的全麻苏醒期躁动的发生率。

Objective To investigate the effect of pre-adaptation of stimulation and preconditioning of lidocaine cream on urinary tract pain after urethral catheterization during anesthetic recovery. Methods 90 male patients undergoing selective thoracic surgery were selected and divided into three groups. Patients in group 1 were performed urinary catheterization routinely before induction of anesthesia. Patients in group 2 were performed urinary catheterization with lidocaine cream 5rain before induction of anesthesia and patients in group 3 were performed urinary catheterization with lidocaine cream after induction of anesthesia. MAP, HR, Bruggrmann comfort scale （BCS）and degree of urinary pain were recorded at recovery of anesthesia（T0）, 10min（T~）, 20rain（T2） and 30min（T3） after recovery of anesthesia. Results MAP and HR were significantly increased at T1, T2 and T3 than those at TO in group 1 and group 3 （P〈0.001）,MAP and HR were significantly increased in groupl and group 3 than those in group2 at the same time point（P〈0.001）. BCS were no difference at the same time point among the three groups. Degree of urinary pain in group 2 were lower than that in group 1 and group3 at T1, T2 and T3. Conclusion Pre-adaptation of stimulation and preconditioning of lidocaine cream could effectively decrease the incidence of excitation due to ta-inary catheterization occurred during recovery of anesthesia.