利多卡因胶浆预防老年男性患者导尿管相关膀胱不适的效果观察

Lidocaine mucilage in the prevention of catheter-related bladder discomfort in elderly male patients

目的观察全麻后无痛导尿时使用利多卡因胶浆涂抹导尿管预防老年男性患者术后导尿管相关膀胱不适的疗效。方法选取2021年3月-2021年6月复旦大学附属华东医院择期行非心脏全身麻醉手术的老年男性患者200例,随机数法分为利多卡因胶浆组(n=100)和常规组(n=100)。利多卡因胶浆组在全身麻醉诱导后插导尿管时,使用利多卡因胶浆涂抹导尿管后行无痛导尿术留置导尿,常规组在全身麻醉诱导后常规行无痛导尿术留置导尿。观察2组术后在麻醉恢复室(post anesthesia care unit,PACU)中的导尿管相关膀胱不适(catheter-related bladder discomfort,CRBD)的分级、患者Riker评分、PACU中心率、血压、拔管时间等。结果利多卡因胶浆组CRBD发生率低于常规组(29%Vs 54%)(P<0.01);重度CRBD躁动的发生率降低(3%Vs 11%)(P<0.01),在PACU中20 min时,利多卡因胶浆组心率收缩压及Riker评分较常规组低(4.1±0.5)vs(4.5±0.8)(P<0.05);拔管时间差异无统计学意义。结论使用利多卡因胶浆涂抹导尿管预防老年男性患者术后导尿管相关膀胱不适的效果确切,有利于提高患者舒适度。

Objective To investigate the effect of lidocaine gel applied to the catheter during painless catheterization after general anesthesia on preventing catheter-related bladder discomfort(CRBD)in elderly male patients.Methods From March 2021 to June 2021,200 elderly male patients underwent elective non-cardiac general anesthesia in Huadong Hospital Affiliated to Fudan University were selected and randomly divided into lidocaine gel group(n=100)and conventional group(n=100).In the lidocaine gel group,after induction of general anesthesia and before inserting the catheter,the catheter was smeared with lidocaine gel,and then painless catheterization was performed.In the conventional group,painless catheterization was performed routinely after the induction of general anesthesia.The incidence and grade of CRBD,Riker score,blood pressure,heart rate and extubation time in postanesthesia care unit(PACU)were observed and compared between the two groups.Results The incidence of CRBD in the lidocaine gel group was lower than that in the conventional group(29%VS 54%,P<0.01),and the incidence of severe CRBD agitation in the lidocaine gel group was lower than that in the conventional group(3%vs 11%,P<0.01).At 20 minutes in PACU,the heart rate,systolic blood pressure and Riker score[(4.1±0.5)vs(4.5±0.8)]of the lidocaine gel group were lower than those of the conventional group(P<0.05).There was no significant difference in extubation time between the two groups.Conclusion Lidocaine gel has a definite effect on preventing CRBD in elderly male patients,which is conducive to improving the comfort of patients.