地佐辛对全身麻醉术后导尿管相关性膀胱刺激征的预防作用

The preventive effect of dezocine on urinary catheter related bladder discomfort after general anesthesia

目的探讨地佐辛对全身麻醉术后导尿管相关性膀胱刺激征（Catheter Related Badder Discomfort，CRBD）的预防价值。方法选取2014年2月至2016年5月期间本院收治的全麻腹腔镜下胆囊切除术患者68例，所有患者均需留置导尿管。按照是否预防性应用地佐辛将其分为观察组和对照组，两组患者均在全麻诱导后插入导尿管。在手术结束前20min，观察组患者取地佐辛0．1mg／kg静脉推注，对照组患者则取0．9％氯化钠0．05ml／kg静脉推注，对两组患者拔管后不同时间点膀胱刺激征的发生情况及严重程度等进行观察分析。结果观察组患者的CRBD发生率及严重程度均明显低于对照组，差异有统计学意义（P〈0．05）；观察组患者在拔管后不同时刻Riker镇静一躁动评分均明显低于对照组，差异有统计学意义（P〈0．05）。结论对于全身麻醉留置导尿管患者，在手术结束前20min给予患者地佐辛静推可有效降低CRBD的发生风险，对于减轻患者痛苦，促进其术后顺利恢复具有十分积极的意义，建议在临床进一步推广应用。

Objective To explore the value ofdezocine in the prevention of urinary catheter related bladder discomfort （CRBD） after general anesthesia. Methods 68 patients undergoing laparoscopic cholecystectomy under general anesthesia in our hospital from February 2014 to May 2016 were selected, all patients required indwelling catheter. All patients were divided into the observation group and the control group according to whether the prophylactic application of dezocine, patients of two groups were inserted urinary catheter after induction of general anesthesia. Twenty minutes before the end of the operation, the patients in the observation group were treated with intravenous injection of 0.1 mg/kg of dezocine, while the patients in the control group were treated with intravenous injection of 0.05 ml/kg of 0.9% sodium chloride. After the extubation, the occurrence and severity of CRBD were observed and analyzed. Results The incidence and severity of CRBD in the observation group were significantly lower than those in the control group （P〈0.05）. Riker sedation-restlessness score of the observation group was significantly lower than that of the control group at different time points after the extubation （P〈0.05）. Conclusion For patients indwelling catheter under general anesthesia, intravenous injection of dezocine 20 minutes before the end of the operation can effectively reduce the risk of CRBD, has very positive significance in the reduction of pain and promoting the smooth recovery of patients, which is recommended to further promote in clinical.