地佐辛对全身麻醉后导尿管相关性膀胱刺激征的预防作用

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后导尿管相关性膀胱刺激征(catheter-related bladder discomfort,CRBD)的预防作用。方法选取广州医科大学附属第一医院海印院区2022年4月—2023年3月收治的60例经皮肾镜取石术全麻手术患者,根据术前是否注射地佐辛分为观察组与对照组。对照组手术结束前20 min静脉注射2 mL生理盐水;观察组手术结束前20 min静脉注射地佐辛0.1 mg/kg。比较2组疼痛程度[视觉模拟评分法(visual analogue scale,VAS)]、CRBD发生情况、术中舒芬太尼使用剂量、拔出气管导管后镇静程度、平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)。结果观察组拔管后、拔管后15 min、30 min、1 h、2 h、4 h的VAS评分低于对照组(P<0.05);观察组CRBD严重程度优于对照组(P<0.05);观察组术中舒芬太尼使用剂量为(0.31±0.17)μg/kg,低于对照组的(0.62±0.22)μg/kg(P<0.05),观察组镇静程度评分为(2.34±0.26)分,低于对照组的(5.27±0.36)分(P<0.05);观察组在T1、T2、T3、T4时的MAP、HR低于对照组(P<0.05)。结论地佐辛对全身麻醉术后CRBD具有明显预防作用,可缓解疼痛,保持生命体征平稳,可以提高镇静效果,减少舒芬太尼使用剂量,应用价值高。

Objective To investigate the preventive effect of dezocine on urinary catheter-related bladder discomfort(CRBD)after general anesthesia.Methods A total of 60 patients undergoing percutaneous nephrolithotomy under general anesthesia admitted to Haiyin Hospital the First Affiliated Hospital of Guangzhou Medical University from April 2022 to March 2023 were selected and divided into observation group and control group according to whether dizocine was injected before surgery.The control group was given 2 mL of normal saline intravenously 20 min before the end of the operation.Observation group received intravenous injection of dezocine 0.1 mg/kg 20 min before the end of operation.The pain degree of[visual analogue scale(VAS)],occurrence of CRBD,intraoperative dose of sufentanil,degree of sedation after tracheal catheter withdrawal,mean arterial pressure(MAP),heart rate(HR)were compared between the two groups.Results The VAS scores of observation group after extubation,15 min,30 min,1 h,2 h and 4 h were lower than those of control group(P<0.05).The severity of CRBD in observation group was better than that in control group(P<0.05).The intraoperative dose of sufentanil in the observation group was(0.31±0.17)μg/kg,lower than that in the control group(0.62±0.22)μg/kg(P<0.05),and the score of sedation degree in the observation group was(2.34±0.26)points,lower than that in the control group(5.27±0.36)points(P<0.05).The MAP and HR of the observation group at T1,T2,T3 and T4 were lower than those of the control group(P<0.05).Conclusion Dezocine has obvious preventive effect on urinary CRBD after general anesthesia,can relieve pain,keep vital signs stable,improve sedation effect,reduce the dosage of sufentanil,and has high application value.