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阿托品对因膀胱肿瘤接受经尿道切除术患者预防导管相关疼痛和不适的效果;前瞻性随机对照研究。

The effect of atropine in preventing catheter-related pain and discomfort in patients undergoing transurethral resection due to bladder tumor; prospective randomized, controlled study.

作者信息

Şahiner Yeliz, Yağan Özgür, Akdağlı Ekici Arzu, Ekici Musa, Demir Emre

机构信息

Department of Anesthesiology and Reanimation, Erol Olçok Training and Research Hospital, Hitit University Faculty of Medicine, Çorum, Turkey.

Department of Urology, Erol Olçok Training and Research Hospital, Hitit University Faculty of Medicine, Çorum, Turkey.

出版信息

Korean J Pain. 2020 Apr 1;33(2):176-182. doi: 10.3344/kjp.2020.33.2.176.

Abstract

BACKGROUND

Catheter-related bladder discomfort (CRBD) has been observed in many patients undergoing a urethral catheterization. CRBD may be so severe that the patients require additional analgesics. Muscarinic receptors are involved in the mechanism of CRBD. The aim of this study is to determine the effects of the antimuscarinic properties of atropine, which is frequently used in current practice on CRBD, by comparing it with sugammadex which has no antimuscarinic effects.

METHODS

Sixty patients selected for transurethral resection due to bladder tumors were randomized into 2 groups: an atropine group and a sugammadex group, with no antimuscarinic effect. The patients were given rocuronium (0.6 mg/kg) as a neuromuscular- blocker. In addition to the frequency and severity of CRBD postoperatively at 0, 1, 6, 12, and 24 hours, postoperative numeric rating scale (NRS) scores, and postoperative nausea and vomiting were examined.

RESULTS

The incidence of CRBD was significantly lower in the atropine group in all postoperative measurements. The score was found to be significantly lower in the atropine group when NRS measurements were performed at all time periods ( < 0.01). There was no difference between the groups in terms of nausea and vomiting ( > 0.05).

CONCLUSIONS

Atropine is a cheap, easy-to-access, safe-to-use drug for reducing CRBD symptoms, without any observed adverse effects. Since it not only reduces CRBD symptoms but also has a positive effect on postoperative pain, it can be used safely to increase patient comfort in patients receiving general anesthesia and a urinary catheter.

摘要

背景

许多接受尿道插管的患者都出现过导尿管相关膀胱不适(CRBD)。CRBD可能非常严重,以至于患者需要额外的镇痛药。毒蕈碱受体参与了CRBD的发病机制。本研究的目的是通过将常用的阿托品的抗毒蕈碱特性与无抗毒蕈碱作用的舒更葡糖钠进行比较,来确定其对CRBD的影响。

方法

因膀胱肿瘤而选择经尿道切除术的60例患者被随机分为两组:阿托品组和无抗毒蕈碱作用的舒更葡糖钠组。患者接受罗库溴铵(0.6mg/kg)作为神经肌肉阻滞剂。除了术后0、1、6、12和24小时CRBD的频率和严重程度外,还检查了术后数字评分量表(NRS)评分以及术后恶心和呕吐情况。

结果

在所有术后测量中,阿托品组CRBD的发生率显著较低。在所有时间段进行NRS测量时,发现阿托品组的评分显著较低(<0.01)。两组在恶心和呕吐方面无差异(>0.05)。

结论

阿托品是一种廉价、易于获取、使用安全的药物,可减轻CRBD症状,且未观察到任何不良反应。由于它不仅能减轻CRBD症状,还对术后疼痛有积极作用,因此可安全用于提高接受全身麻醉和留置导尿管患者的舒适度。

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Korean J Pain. 2020 Jul 1;33(3):288-289. doi: 10.3344/kjp.2020.33.3.288.

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