苏醒前利多卡因膀胱冲洗减轻麻醉恢复期导尿管刺激的临床观察

Early bladder irrigation with lidocaine reduces catheter stimulation during anesthesia recovery period

2019年5—9月采用前瞻性研究方法,将郴州市第一人民医院麻醉科全身麻醉苏醒前的60例45~65岁、美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级男性患者,随机分为L组和C组,均为30例,在患者苏醒前L组采用100 mg利多卡因+生理盐水共20 ml、C组采用生理盐水20 ml行膀胱冲洗,夹闭5 min放开,观察患者清醒是否有尿意,尿道刺激感评分,无意识抓导尿管行为,出现尿管相关躁动以及需要补救用药的情况。L组尿道刺激评分(1.94±0.15)分,有尿意者2例,无意识抓导尿者1例,未发生躁动及补救用药情况,C组分别为(3.95±0.69)分,有尿意者12例,无意识抓导尿者10例、躁动者6例,补救用药12例。提示,麻醉苏醒前期使用利多卡因进行膀胱冲洗可以减轻麻醉苏醒期导尿管相关刺激的症状。

Sixty ASAⅠ-Ⅱmale patients aged 45-65 yrs undergoing general anesthesia in Chenzhou First People′s Hospital from May to September 2019 were randomly divided into two groups with 30 cases in each.Before the recover from anesthesia,patients in group L were irrigated with 100 mg lidocaine and 20 ml normal saline through the urinary catheter,while those in group C were irrigated with 20 ml normal saline in the same way.After irrigation,the catheter was clamped for 5 min and then released.The of urination intention when patient is conscious was observed and urethral irritation score was assessed.The cases of unconscious catheter grasping behavior,catheter-related restlessness and the need for rescued medication were compared between two groups.Compared to group C,group L had lower urinary intention rate(3.3%),lower urethral irritation score(1.94±0.15),lower rate of unconscious catheter grasping(6%),lower incidence of catheter agitation(0)and remedial medication(0).It is suggested that bladder irrigation with lidocaine before anesthesia recovery can reduce the symptoms of catheter-related irritation.