不同剂量盐酸戊乙奎醚防治全身麻醉苏醒期导尿管不适的效果比较

Preventive and therapeutic effects of different doses of penehyclidine hydrochloride on the catheter - related bladder discomfort during general anesthesia recovery period

目的比较不同剂量的盐酸戊乙奎醚术前给药防治全麻苏醒期导尿管不适的效果。方法择期全身麻醉下手术的成年患者160例，采用随机数字表法分为四组，术前30min静注盐酸戊乙奎醚0．005mg／kg（A组）、0．010mg／kg（B组）、0．015mg／kg（C组）和0．9％氯化钠注射液（D组）。四组均在全麻诱导后留置12F双腔气囊乳胶导尿管并在气囊内注入0．9氯化钠注射液8mL，术后在麻醉恢复室对苏醒期导尿管不适程度按照轻、中、重度进行评估。结果B组和C组术后中度及重度导尿管不适发生率（B组20．0％和5．0％；C组12．8％和2．5％）明显低于A组和D组（A组38．5％和12．8％；D组46．0％和15．4％）（χ^2=7．834、6．764、8．163、14．172、8．362、6．943、15．413、17．512，均P〈0．05），B组和C组以及A组和D组之间差异无统计学意义。结论术前应用盐酸戊乙奎醚0．010mg／kg和0．015mg／kg均可有效地防治全麻苏醒期导尿管不适的发生，老年人以0．010mg／kg为宜。

Objective To investigate the preventive and therapeutic effects of different doses of penehyclidine hydrochloride preoperative medication on the catheter-related bladder discomfort during general anesthesia recovery period. Methods 160 adult patients who underwent general anesthesia for elective surgery were randomly dividided into four groups. 40 patients in each group received intravenous injection 30min before surgery with penehyclidine hydroehloride 0.005mg/kg （ group A） ,0. 010mg/kg （ group B） ,0. 015mg/kg （ group C）, or normal saline （ group D）. All patients were catheterized with a 12 Fr Foleyb catheter and the balloon was inflated with 8mL normal saline after anesthesia induction. The bladder discomfort was assessed during recovery in the post - anesthesia care unit. The severity of bladder discomfort was graded as mild, moderate and severe. Results The incidence of moderate and severe bladder discomfort in group B and group C （ group B ：20.0%, 5.0% ;group C ： 12.8 %,2.5 % ） were significant lower compared with group A and group D （group A： 38.5%, 12.8% ;group D：46.0% 15.4% ） （χ^2 = 7. 834, 6. 764,8. 163,14. 172,8. 362,6. 943,15. 413,17. 512, all P 〈 0.05 ）. There was no significant difference between group B and group C, group A and group D. Conclusion Hydrochloride penehyclidine preoperative administration with 0. 010mg/kg or 0.015mg/kg can effectively control the incidence of catheter discomfort during general anesthesia recovery period and 0.010mg/kg is appropriate for the elderly.