加热的奥布卡因凝胶在经直肠超声引导前列腺活检术中的镇痛作用

Analgesic effect of heated oxybuprocaine gel in transrectal ultrasound guided prostate biopsy

目的探讨应用加热的奥布卡因凝胶直肠内局部表面麻醉(intrarectal local anesthesia,IRLA)对经直肠超声引导前列腺活检(transrectal ultrasound guided prostate biopsy,TRUSPB)术中疼痛的影响。方法前瞻性纳入2023年1月至6月于湖州市中心医院行TRUSPB的150例患者。采用随机数字表法将患者分为A组(常规组)、B组(应用室温下奥布卡因凝胶行IRLA)和C组(应用40℃奥布卡因凝胶行IRLA),每组50例。由对麻醉类型不知情的护士使用视觉模拟评分(visual analogue scale,VAS)对患者各时期的疼痛程度进行评分(VASⅠ:超声探头插入直肠时;VASⅡ:活检过程中;VASⅢ:活检后30min),并比较活检后并发症发生率。结果C组患者VASⅡ评分低于A组和B组,差异有统计学意义(P<0.05)。三组患者的VASⅠ、VASⅢ评分和活检后并发症发生率比较差异无统计学意义(P>0.05);未见奥布卡因凝胶过敏反应。结论在TRUSPB中应用加热的奥布卡因凝胶的IRLA比常规IRLA可更有效地控制疼痛,且不增加并发症发生率。

Objective To investigate the effect of intrarectal local anesthesia(IRLA)with heated oxybuprocaine gel on pain during transrectal ultrasound guided prostate biopsy(TRUSPB).Methods A total of 150 cases patients who underwent TRUSPB in Huzhou Central Hospital from January to June 2023 were prospectively taken into.The patients were randomly divided into group A(routine group),group B(oxybuprocaine gel for IRLA at room temperature)and group C(oxybuprocaine gel for IRLA at 40℃),with 50 cases in each group.Nurses who were unaware of the anesthesia type used visual analog scale(VAS)to score the pain level of patients at each stage(VASⅠ:when the ultrasound probe was inserted into the rectum;VASⅡ:during the biopsy;VASⅢ:30 minutes after biopsy),and the incidence of complications after biopsy were compared.Results The VASⅡscore of group C was lower than that of group A and group B,and the difference was statistically significant(P<0.05).There was no statistically significant difference(P>0.05)in the VASⅠ,VASⅢscores,and incidence of complications after biopsy among the three groups.There was no allergic reaction to oxybuprocaine gel.Conclusion In TRUSPB,IRLA with heated oxybuprocaine gel can effectively control pain without increasing incidence of complications.