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在接受腰椎间盘显微切除术的患者中,术中给予右美托咪定可减轻术后导尿管相关的膀胱不适和疼痛。

Intraoperative administration of dexmedetomidine reduced the postoperative catheter-related bladder discomfort and pain in patients undergoing lumbar microdiscectomy.

作者信息

Kwon Youngsuk, Jang Ji Su, Hwang Sung Mi, Lee Jae Jun, Tark Hyonjin

机构信息

Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, Hallym University School of Medicine, 77 Sakju-ro, Chuncheon, 24253, South Korea.

出版信息

J Anesth. 2018 Feb;32(1):41-47. doi: 10.1007/s00540-017-2425-0. Epub 2017 Nov 2.

DOI:10.1007/s00540-017-2425-0
PMID:29098393
Abstract

PURPOSE

We aimed to evaluate the effect of the intraoperative dexmedetomidine (DEX) on the incidence and severity of catheter-related bladder discomfort (CRBD) after non-urologic surgery. The secondary aim was to find the correlation between the levels of CRBD and postoperative pain sensation.

METHODS

Adult male patients undergoing lumbar microdiscectomy were enrolled. Patients were randomized into two groups. After propofol administration, group D (n = 35) received DEX at a loading dose of 1 μg/kg over 10 min, followed by a continuous infusion of 0.3-0.5 μg/kg/h until the end of surgery. In group C (n = 35), an identical volume of 0.9% saline was infused in the same manner. Induction and maintenance of anesthesia were standardized. The incidence and severity of CRBD, postoperative pain, and adverse effects were assessed at 1, 3, and 6 h after surgery.

RESULTS

The incidence of CRBD was significantly lower in group D than in group C at 1 h (34.3 vs. 62.9%, P = 0.017), 3 h (25.7 vs. 60%, P = 0.004), and 6 h (17.1 vs. 54.3%. P = 0.001) postoperatively. The severity of CRBD at 1, 3, and 6 h postoperatively was less in group D than in group C. Postoperative pain score was significantly lower in group D than in group C at 3 and 6 h postoperatively. Adverse events were comparable between two groups. There was a significant correlation between the severity of CRBD and postoperative pain score.

CONCLUSIONS

Intraoperative administration of DEX is a safe and effective practice for the prevention of CRBD after lumbar microdiscectomy and can reduce postoperative pain.

摘要

目的

我们旨在评估术中使用右美托咪定(DEX)对非泌尿外科手术后导管相关膀胱不适(CRBD)的发生率和严重程度的影响。次要目的是找出CRBD水平与术后疼痛感觉之间的相关性。

方法

纳入接受腰椎间盘显微切除术的成年男性患者。患者被随机分为两组。给予丙泊酚后,D组(n = 35)在10分钟内接受负荷剂量为1μg/kg的DEX,随后以0.3 - 0.5μg/kg/h的速度持续输注直至手术结束。C组(n = 35)以相同方式输注相同体积的0.9%生理盐水。麻醉诱导和维持标准化。在术后1、3和6小时评估CRBD的发生率和严重程度、术后疼痛及不良反应。

结果

术后1小时(34.3%对62.9%,P = 0.017)、3小时(25.7%对60%,P = 0.004)和6小时(17.1%对54.3%,P = 0.001),D组CRBD的发生率显著低于C组。术后1、3和6小时,D组CRBD的严重程度低于C组。术后3和6小时,D组的术后疼痛评分显著低于C组。两组间不良事件相当。CRBD的严重程度与术后疼痛评分之间存在显著相关性。

结论

术中给予DEX是预防腰椎间盘显微切除术后CRBD的一种安全有效的方法,且可减轻术后疼痛。

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