Division of Pelvic Medicine and Reconstructive Surgery, Department of Urology, University of California-Los Angeles Medical Center, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California; Division of Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology (ZC, MLTN, CMT), University of California-Los Angeles Medical Center, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California.
Division of Pelvic Medicine and Reconstructive Surgery, Department of Urology, University of California-Los Angeles Medical Center, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California; Division of Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology (ZC, MLTN, CMT), University of California-Los Angeles Medical Center, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California.
J Urol. 2017 Feb;197(2):519-523. doi: 10.1016/j.juro.2016.07.099. Epub 2016 Sep 21.
There is currently a national shortage of indigo carmine. In efforts to identify the most efficient aid for visualizing ureteral efflux intraoperatively we investigated the time to excretion of phenazopyridine vs a newly identified alternative, sodium fluorescein.
We analyzed prospectively collected data on a cohort of women who underwent pelvic reconstructive surgery in 2015. Per provider preference patterns a number of patients were administered 200 mg phenazopyridine orally with a sip of water 1 hour prior to the start of operative time. Other patients were given 0.5 ml 10% sodium fluorescein intravenously in the operating room. In all cases time was measured between the administration of the agent and the visualization of color changes consistent with agent efflux in an indwelling catheter, which was placed at the start of the operation. Differences in excretion times between the groups were compared with the Wilcoxon rank sum test.
Seven women received phenazopyridine and 5 received sodium fluorescein. Mean excretion time was significantly longer in the phenazopyridine group compared to the sodium fluorescein group (81.9 vs 5.1 minutes, p = 0.0057). Median excretion time for phenazopyridine was 70 minutes (range 59 to 127) and for sodium fluorescein it was 5 minutes (range 3 to 9).
Sodium fluorescein is excreted significantly faster in the operating room compared to phenazopyridine. Depending on the cost of these agents at an institution, in addition to the desire to decrease operative time, this may impact practice patterns and agent selection.
目前靛胭脂短缺。为了确定术中可视化输尿管反流最有效的辅助方法，我们研究了排泄时间，比较了匹那吡啶与新发现的替代药物荧光素钠。
我们前瞻性地分析了 2015 年接受盆腔重建手术的一组女性患者的数据。根据提供者的偏好模式，一些患者在手术开始前 1 小时口服 200mg 匹那吡啶，并用一口水送服。其他患者在手术室静脉注射 0.5ml10%荧光素钠。在所有情况下，测量从给予药物到留置导尿管中出现与药物流出一致的颜色变化之间的时间，该导尿管在手术开始时放置。使用 Wilcoxon 秩和检验比较两组之间的排泄时间差异。
7 名女性接受了匹那吡啶，5 名女性接受了荧光素钠。与荧光素钠组相比，匹那吡啶组的排泄时间明显更长（81.9 分钟对 5.1 分钟，p = 0.0057）。匹那吡啶的排泄中位数为 70 分钟（范围 59 至 127），而荧光素钠为 5 分钟（范围 3 至 9）。
与匹那吡啶相比，荧光素钠在手术室中排泄速度明显更快。根据机构中这些药物的成本，以及减少手术时间的愿望，这可能会影响实践模式和药物选择。
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