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目的 探讨羟考酮对于预防全身麻醉术后导尿管相关膀胱刺激征(CRBD)发生的作用。方法 选取2016年5月至2017年4月首都医科大学附属北京佑安医院收治的择期全身麻醉下行脾切除术的男性患者120例,采用随机数字表法分为羟考酮组和舒芬太尼组,每组60例。2组患者采用相同的手术和麻醉方法,均在麻醉诱导结束后即刻插14号Foley′S导尿管。羟考酮组在手术结束前20 min时静脉注射羟考酮0.1 mg/kg(用0.9%氯化钠注射液稀释至1 mg/ml);舒芬太尼组注射等容量舒芬太尼0.1 μg/kg。记录2组术后6 h内CRBD的发生情况和严重程度,以及其他术后不良反应的发生情况。结果 羟考酮组CRBD发生率明显低于舒芬太尼组[18.3%(11/60)比43.3%(26/60)];且羟考酮组患者的CRBD严重程度明显低于舒芬太尼组,差异均有统计学意义(均P<0.05)。羟考酮组不良反应发生率明显低于舒芬太尼组[3.3%(2/60)比23.3%(14/60)],差异有统计学意义(P<0.05)。结论 对于全身麻醉留置导尿管患者,在手术结束前给予羟考酮相比舒芬太尼可更有效地降低术后CRBD的发生率和严重程度,且不良反应更少。
Preventive effect of oxycodone on postoperative catheter-related bladder discomforts
Cao Mengru, He Haili, Liu Xiaopeng, Song Yanli
Operating Room, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
Corresponding author: He Haili, Email: hehailiya@126.com
【Abstract】Objective To investigate the effect of oxycodone on prevention of postoperative catheter-related bladder discomforts(CRBD). Methods Totally 120 male patients undergoing selective splenectomy with general anesthesia in Beijing YouAn Hospital, Capital Medical University from May 2016 to April 2017 were randomly divided into oxycodone group and sulfentanyl group, with 60 patients in each group. All patients had urethral catheter intubation at the end of anesthesia induction. The oxycodone group was intravenously injected oxycodone 0.1 mg/kg(diluted to 1 mg/ml in 0.9% sodium chloride solution) and the sulfentanyl group was intravenously injected same volume of sulfentanyl(0.1 μg/kg)at 20 min before the end of operation. Occurrence and severity of CRBD in 6 h after operation and other adverse reactions were observed. Results Incidence rate[18.3%(11/60) vs 43.3%(26/60)] and severity of CRBD in oxycodone group were significantly lower than those in sulfentanyl group(P<0.05). Adverse reaction rate in oxycodone group was significantly lower than that in sulfentanyl group[3.3%(2/60) vs 23.3%(14/60)](P<0.05). Conclusion Preventive administration of oxycodone can safely and effectively reduce incidence and severity of CRBD in patients indwelling catheter after general anesthesia.
【Key words】Catheter-related bladder discomforts;Oxycodone;Sufentanil
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