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术中使用对乙酰氨基酚对导尿管相关膀胱不适的影响:一项前瞻性、随机、双盲研究。

Effect of intraoperative paracetamol on catheter-related bladder discomfort: a prospective, randomized, double-blind study.

作者信息

Ergenoglu Pinar, Akin Sule, Yalcin Cok Oya, Eker Evren, Kuzgunbay Baris, Turunc Tahsin, Aribogan Anis

机构信息

Anesthesiology and Reanimation Department, Baskent University School of Medicine, Adana,Turkey.

Department of Urology, Baskent University School of Medicine, Adana, Turkey.

出版信息

Curr Ther Res Clin Exp. 2012 Dec;73(6):186-94. doi: 10.1016/j.curtheres.2012.08.001.

Abstract

BACKGROUND

The insertion of urinary catheters during urinary surgical interventions may lead to catheter-related bladder discomfort (CRBD) in the postoperative period.

OBJECTIVE

We aimed to evaluate the effect of single-dose intravenous paracetamol on CRBD.

METHODS

In this randomized, controlled, double-blind study, 64 patients (age >18 years, American Society of Anesthesiologists Physical Status I-II) requiring urinary bladder catheterization for percutaneous nephrolithotomy were assigned to groups that received either intravenous paracetamol (15 mg/kg) (group P) or NaCl 0.9% solution (control group [group C]) 30 minutes before the end of surgery. Patients received patient-controlled analgesia (10-mg bolus of meperidine, without infusion, 20-minute lock out) postoperatively. CRBD and pain status were assessed at 30 minutes and 1, 2, 4, 6, and 12 hours postoperatively. Postoperative meperidine requirement and patient and surgeon satisfaction were assessed.

RESULTS

Group P had significantly lower CRBD scores at all time points except at 12 hours postoperatively compared with group C (P < 0.05). Total meperidine consumption was significantly higher in group C (P < 0.05). Patient and surgeon satisfaction scores were significantly higher in group P (P < 0.05).

CONCLUSIONS

Intraoperative single-dose paracetamol was found to be effective in reducing the severity of CRBD and pain in urologic surgery. We suggest that it may be an efficient, reliable, easy-to-apply drug for CRBD. ClinicalTrials.gov identifier: NCT01652183.

摘要

背景

泌尿外科手术期间插入导尿管可能会导致术后出现导尿管相关膀胱不适(CRBD)。

目的

我们旨在评估单剂量静脉注射对乙酰氨基酚对CRBD的影响。

方法

在这项随机、对照、双盲研究中,64例因经皮肾镜取石术需要插入膀胱导尿管的患者(年龄>18岁,美国麻醉医师协会身体状况分级I-II级)被分为两组,在手术结束前30分钟分别接受静脉注射对乙酰氨基酚(15mg/kg)(P组)或0.9%氯化钠溶液(对照组[C组])。术后患者接受患者自控镇痛(10mg哌替啶推注,无输注,锁定时间20分钟)。在术后30分钟、1、2、4、6和12小时评估CRBD和疼痛状况。评估术后哌替啶需求量以及患者和外科医生的满意度。

结果

与C组相比,除术后12小时外,P组在所有时间点的CRBD评分均显著较低(P<0.05)。C组的哌替啶总消耗量显著更高(P<0.05)。P组的患者和外科医生满意度评分显著更高(P<0.05)。

结论

术中单剂量对乙酰氨基酚被发现可有效减轻泌尿外科手术中CRBD的严重程度和疼痛。我们认为它可能是一种治疗CRBD的高效且可靠、易于应用的药物。ClinicalTrials.gov标识符:NCT01652183。

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