Cho Choon-Kyu, Chang Minhye, Lee Seok-Jin, Cho Sung-Ae, Sung Tae-Yun
Department of Anesthesiology and Pain Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
Anesth Pain Med (Seoul). 2022 Apr;17(2):157-164. doi: 10.17085/apm.21066. Epub 2021 Oct 14.
The presence of a urinary catheter, postoperative pain, and postoperative nausea and vomiting are risk factors for emergence agitation (EA). Antimuscarinic agents are primary agents used in the prevention and treatment of urinary catheter-related bladder discomfort. Chlorpheniramine has antimuscarinic, antinociceptive, and antiemetic effects. This retrospective study investigated the role of chlorpheniramine in EA prevention following ureteroscopic stone surgery.
Of 110 adult patients who underwent ureteroscopic stone surgery under general anesthesia between January and December 2019, the medical records of 93 patients were analyzed retrospectively. The patients were divided into control (n = 52) and chlorpheniramine (n = 41) groups according to the receipt of intravenous chlorpheniramine before the induction of anesthesia. The incidence and severity of EA were compared between the groups as primary and secondary endpoints, respectively. The effects of chlorpheniramine on the requirement for inhalation anesthetic (desflurane) during surgery, changes in mean blood pressure and heart rate during emergence, and adverse events were also compared.
The incidence (21.2% in the control group, 24.4% in the chlorpheniramine group) and severity of EA did not differ between groups. The intraoperative requirement for desflurane, changes in mean blood pressure and heart rate during emergence, and adverse events were also similar between groups.
Chlorpheniramine was not associated with a decrease in EA incidence or severity in patients who underwent ureteroscopic stone surgery.
导尿管的存在、术后疼痛以及术后恶心呕吐是苏醒期躁动（EA）的危险因素。抗胆碱能药物是预防和治疗导尿管相关膀胱不适的主要药物。氯苯那敏具有抗胆碱能、镇痛和止吐作用。本回顾性研究探讨了氯苯那敏在输尿管镜取石术后预防EA中的作用。
回顾性分析2019年1月至12月期间110例在全身麻醉下接受输尿管镜取石术的成年患者的病历，其中93例患者纳入分析。根据麻醉诱导前是否接受静脉注射氯苯那敏，将患者分为对照组（n = 52）和氯苯那敏组（n = 41）。分别将两组EA的发生率和严重程度作为主要和次要终点进行比较。还比较了氯苯那敏对手术期间吸入麻醉药（地氟醚）需求、苏醒期间平均血压和心率变化以及不良事件的影响。
两组EA的发生率（对照组为21.2%，氯苯那敏组为24.4%）和严重程度无差异。两组术中对地氟醚的需求、苏醒期间平均血压和心率的变化以及不良事件也相似。
氯苯那敏与输尿管镜取石术患者EA的发生率或严重程度降低无关。
