碱化利多卡因膀胱冲洗联合复方利多卡因乳膏可减轻导尿管相关膀胱刺激症

Bladder washing by alkalinized lidocaine combined with compound lidocaine cream alleviates catheter-related bladder discomfort

目的观察碱化利多卡因膀胱冲洗联合复方利多卡因乳膏防治全麻恢复期导尿管相关膀胱刺激症(CRBD)的疗效。方法将120例择期全麻下行上腹部手术的男性患者,随机分为4组:对照组(C组)、复方利多卡因乳膏组(L组)、碱化利多卡因膀胱冲洗组(B组)、碱化利多卡因膀胱冲洗联合利多卡因乳膏组(L+B组)。观察四组患者CRBD的发生情况和CRBD源性躁动发生率,并记录患者手术结束前5 min(T1)、气管拔管后5 min(T2)、气管拔管后30 min(T3)的心率(HR)、血压(MAP)、血氧饱和度(SpO2)和视觉模拟评分(VAS)。结果四组患者间HR、MAP、SpO2、VAS的差异无统计学意义(P>0.05)。L+B组CRBD发生率和CRBD源性躁动发生率明显低于其他3组(P<0.05),L组和B组也低于C组(P<0.05)。结论碱化利多卡因膀胱冲洗联合复方利多卡因乳膏可明显减轻全麻恢复期导尿管相关膀胱刺激症状。

Objective To evaluate the effect of bladder washing by alkalinized lidocaine combined with compound lidocaine cream on catheter-related bladder discomfort （CRBD） in general anesthesia patients during postoperative recovery. Methods A total of 120 male patients undergoing upper abdominal surgery were divided into four groups：control group, lidocaine cream group, bladder washing by alkalinized lidocaine group, combination group. The incidence of CRBD and the rates of agitation caused by CBRD were recorded and compared among four groups. HR, MAP, SpO2 and VAS score were assessed at 5 min before operation,5 min, 30 min after extubation. Results HR, MAP, SpO2 and VAS score had no statistical significance among four groups （ P 〉 0.05 ）. The incidence of CRBD and rates of agitation caused by CBRD in combination group were significantly lower than those in the other groups （ P 〈 0.05 ）, and they were also significantly lower in lidocaine cream group and bladder washing by alkalinized lidocaine group than those in control group （ P 〈 0. 05）. Conclusion Bladder washing by alkalinized lidocaine combined with compound lidocaine cream can significantly allevi- ate the incidence of catheter related bladder discomfort in general anesthesia patients during postoperative recovery.