右美托咪定预防经尿道前列腺电切术后导尿管相关膀胱刺激征的效果

Effects of dexmedetomidine on preventing catheter-related bladder discomfort in patients undergoing transurethral resection of prostate

目的观察不同负荷剂量右美托咪定(Dex)预防经尿道前列腺电切(TURP)术后导尿管相关膀胱刺激征(CRBD)的效果。方法选取择期行前列腺电切术患者120例,随机分为A,B,C 3组,每组40例。全麻诱导前给予A,B组患者右美托咪定0.5μg/kg,1μg/kg,10min内泵注完成,随后以0.2μg/(kg·h)的浓度维持,直至手术结束前30min停药;C组患者给与等体积0.9%生理盐水。记录术后30min(T1)、2h(T2)、6h(T3)CRBD严重程度评分、Riker镇静-躁动评分、VAS评分以及不良事件发生情况。结果A,B组术后CRBD发生率显著低于C组(P<0.05),且B组在T1,T2时刻CRBD发生率显著低于A组(P<0.05);与C组相比,A,B组在T1,T2,T3时刻VAS评分显著降低(P<0.05),两组间差异无统计学意义(P>0.05);与C组相比,A,B组在T1,T2时刻Riker镇静-躁动评分明显降低(P<0.05),且B组显著低于A组(P<0.05)。结论全麻诱导前10min给予1μg/kg Dex更有助于减轻行TURP患者术后CRBD发生率,并具有更好的镇静效果。

Objective To observe the effects of dose-dependence of dexmedetomidine(Dex)on catheter-related bladder discomfort(CRBD)in patients undergoing transurethral resection of prostate(TURP).Methods A total of 120 male patients,undergoing TURP,aged 60~80 years,with BMI 18~25 kg/m2,were randomly divided into 3 groups(group A,group B and group C),equal samples in each group.Patients in Group A and B were administrated 0.5μg/kg or 1μg/kg Dex respectively by intravenous pumping 10 mins before induction of anesthesia,and then Dex 0.2μg/(kg·h)had been continuously given in both groups till 30 mins before the surgery ended;Group C received equivalent normal saline instead of Dex.CRBD graded scores,VAS scores,Riker scores and adverse events were assessed at 30 min(T1),2 h(T2),6 h(T3)after surgery.Results The CRBD scores of both Group A and Group B were significantly lower than those of Group C(P<0.05),and the CRBD scores of Group B were significantly lower than those of Group A at the time point of T1 and T2(P<0.05).Compared with Group C,the VAS scores of Group A and Group B were significantly lower at T1,T2 and T3(P<0.05),but there was no difference between Group A and Group B(P>0.05).The Riker scores of Group A and Group B were significantly lower than Group C at T1 and T2(P<0.05),and the Riker scores of Group B were significantly lower than Group A at T1 and T2(P<0.05).Conclusion Preoperative administration of Dex at 1μg/kg has more efficiency in reducing the incidence of CRBD,and ameliorates the sedative effect as well.