利多卡因联合消炎痛栓预防老年男性患者术后导尿管源性躁动

Combined use of lidocaine and indomethacin suppository prevents postoperative urethral catheter-induced agitation in male elderly patients

目的探讨利多卡因联合消炎痛栓预防老年男性患者术后导尿管源性躁动的效果。方法全麻下行非泌尿外科手术的老年男性患者268例,随机分为利多卡因组(A组,57例,术后即刻导尿管注入1%利多卡因20ml)、消炎痛栓组(B组,54例,肛门塞入消炎痛栓100mg)、利多卡因联合消炎痛栓组(C组,57例)和对照组(D组,100例),记录四组患者全麻苏醒期(T1)躁动的发生率及其程度以及出麻醉后监测治疗室(T2)、术后24h(T3)时尿管刺激感的发生率及其程度。结果 T1时,A、B、C组躁动发生率及其程度均低于D组(P<0.05);T2时,A、C组的尿路刺激感发生率低于D组(P<0.05),A、B、C组的尿管刺激感程度均低于D组(P<0.05);T3时,A、B、C组尿管刺激感发生率和尿管刺激感程度均低于D组(P<0.05)。结论联合应用利多卡因和消炎痛栓能有效降低老年男性患者全麻苏醒期导尿管源性躁动,提升全麻苏醒质量。

Objective To observe the preventive effect of lidocaine combined with indomethacin suppository on postoperative urethral catheter-induced agitation in male elderly patients.Methods A total of 268 male elderly patients undergoing non-urologic operation under general anesthesia was randomly divided into 4 groups of A（injected with 1% lidocaine 20 ml in the urethral catheter immediatedly after operation,57cases）,B（inserted indomethacin suppository 100 mg into the rectum,54cases）,C（combined use of lidocaine and indomethacin suppository,57cases）and D（without any treatment as the control,100cases）.The incidence and degree of agitation during anesthesia recovery period（T1）and those of urinary catheter stimulation in post-anesthesia care unit（T2）and at 24 hours after operation（T3）were recorded.Results The incidence and degree of agitation in groups of A,B and C were lower than those in group D at T1（P〈0.05）.The incidence of urinary catheter stimulation in groups of A and C and the degree of urinary catheter stimulation in groups of A,B and C were lower than those in group D at T2（P〈0.05）.The incidence and degree of urinary catheter stimulation in groups of A,B and C were lower than those in group D at T3（P〈0.05）.Conclusion Combined use of lidocaine and indomethacin suppository can reduce postoperative urethral catheterinduced agitation in male elderly patients and improve the recovery quality of general anesthesia.