术中使用羟考酮可减轻经尿道前列腺切除术后与导尿管相关的膀胱不适。一项前瞻性、双盲随机研究。

Intra-operative Oxycodone Reduced Postoperative Catheter-Related Bladder Discomfort Undergoing Transurethral Resection Prostate. A Prospective, Double Blind Randomized Study.

作者信息

Xiong Juncheng, Chen Xiang, Weng Chengwei, Liu Shuqun, Li Jian

机构信息

Department of anesthesiology, Wenzhou people's hospital. No.57 canghou street, Lucheng District of Wenzhou City, Zhejiang province, People Republic of China, 325000.

Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbaixiang Ouhai District of Wenzhou, Zhejiang, P. R. China, 325000.

出版信息

Urol J. 2019 Aug 18;16(4):392-396. doi: 10.22037/uj.v0i0.4267.

DOI:10.22037/uj.v0i0.4267

PMID:30852837

Abstract

PURPOSE

To observe the efficacy of intravenously injected oxycodone intraoperative on postoperative urinary catheter-related bladder discomfort (CRBD).

MATERIALS AND METHODS

Patients with ASA I-III received trans-urethral resection prostate under general anesthesia were observed. Patients were randomized allocated to the group control (n = 45) received placebo and the group oxycodone (n =46 ) received 0.03mg/kg of oxycodone before the end of operative 10min. The incidence and severity (mild, moderate, severe) of CRBD were assessed at 0, 1/2 h, 2 h and 6 h postoperatively. VAS scores were used to assess pain intensity during the same period. Postoperative PCA analgesic sufentanil dose and the incidences of nausea, vomiting, dizziness, over sedation were recorded in these patients.

RESULTS

Compared with the control group, the incidence of CRBD was significantly lower in the oxycodone group at 0 [22 (49 %) vs. 10 (22%); P = .007], 1/2h [18 (40%) vs. 9 (20%); P= .033], 2h [11 (24%) vs. 4 (9%); P = .001]. The severity of CRBD at 0 [mild, 9 (38%) ; moderate 9 (20%), severe 4 (9%)] was lower in the group Q than the controlled group [mild, 4 (38%) P ? .023; moderate 5 (11%), P ?.034, severe 1 (2%), P ? .012]. 1/2 h [mild, 11 (24%) Vs 5(11%), P ? .020]. Compared with the group C, VAS scores were lower in group Q at 0, 1/2h (P ? .001) and significantly decreased sufentanil dosage within 6h ( P= .001). There were no significant differences in the incidence of postoperative adverse effects between two groups.

CONCLUSION

Oxycodone can effectively prevent patients with CRBD after TURP without incurring serious adverse effects.

摘要

目的

观察术中静脉注射羟考酮对经尿道前列腺电切术（TURP）术后导尿管相关膀胱不适（CRBD）的疗效。

材料与方法

观察美国麻醉医师协会（ASA）分级为I - III级、在全身麻醉下行TURP的患者。患者被随机分为对照组（n = 45），在手术结束前10分钟接受安慰剂；羟考酮组（n = 46），在手术结束前10分钟接受0.03mg/kg羟考酮。在术后0、0.5小时、2小时和6小时评估CRBD的发生率和严重程度（轻度、中度、重度）。在同一时期使用视觉模拟评分法（VAS）评估疼痛强度。记录这些患者术后自控镇痛（PCA）舒芬太尼剂量以及恶心、呕吐、头晕、过度镇静的发生率。

结果

与对照组相比，羟考酮组在术后0小时[22例（49%） vs. 10例（22%）；P = 0.007]、0.5小时[18例（40%） vs. 9例（20%）；P = 0.033]、2小时[11例（24%） vs. 4例（9%）；P = 0.001]时CRBD的发生率显著更低。羟考酮组术后0小时CRBD的严重程度[轻度9例（38%）；中度9例（20%），重度4例（9%）]低于对照组[轻度4例（38%），P = 0.023；中度5例（11%），P = 0.034，重度1例（2%），P = 0.012]。0.5小时[轻度11例（24%） vs. 5例（11%），P = 0.020]。与对照组相比，羟考酮组在术后0、0.5小时的VAS评分更低（P = 0.001），且6小时内舒芬太尼剂量显著减少（P = 0.001）。两组术后不良反应发生率无显著差异。