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盐酸丁卡因胶浆表面麻醉联合静脉麻醉用于无痛膀胱镜检查的研究

Research on the use of tetracaine hydrochloride jelly surface anesthesia in combination with intravenous anesthesia for pain-free cystoscopy.

作者信息

Bai Wenjie, Luo Daxun, Wurige Mule, Xiao Bo, Li Jianxing

机构信息

Department of Urology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.

出版信息

Front Med (Lausanne). 2025 Sep 3;12:1653269. doi: 10.3389/fmed.2025.1653269. eCollection 2025.

Abstract

OBJECTIVE

This study aimed to evaluate the efficacy and safety of tetracaine hydrochloride jelly surface anesthesia in combination with intravenous anesthesia for painless cystoscopy.

METHODS

This study was conducted at the Department of Urology, Beijing Tsinghua Changgung Hospital, from 1 January 2023 to 31 December 2024. A total of 60 eligible inpatients were recruited based on predefined inclusion and exclusion criteria and were randomly allocated to two groups, each comprising 30 patients. The experimental group received tetracaine hydrochloride jelly in conjunction with intravenous anesthesia, whereas the control group received intravenous anesthesia alone. Both groups were administered a slow intravenous infusion of 1.5 mg/kg propofol (1%) and 0.15 μg/kg remifentanil. After 2 min, the experimental group received 10 mL of tetracaine hydrochloride jelly via the urethra, while the control group received 10 mL of glycerin. The surgical procedure commenced 4 min later. Throughout the procedure, patients maintained spontaneous breathing, and additional propofol was administered if necessary. Preoperative parameters, including propofol dosage, cystoscopy time, anesthesia/awakening time, and relevant vital signs, were recorded for both groups.

RESULTS

Compared to the control group, the experimental group required significantly less additional propofol, had shorter anesthesia, cystoscopy, and surgical times, and exhibited higher postoperative SpO₂ levels. No postoperative complications or adverse events were observed in either group.

CONCLUSION

The combination of tetracaine hydrochloride jelly surface anesthesia and intravenous anesthesia demonstrated significant advantages in painless cystoscopy, effectively reducing the additional dosage of propofol, shortening examination time, improving postoperative oxygenation, and ensuring high safety. This approach has considerable clinical value and potential for widespread application.

CLINICAL TRIAL REGISTRATION

ChiCTR2300070527, Date of registration:2023-04-14.

摘要

目的

本研究旨在评估盐酸丁卡因凝胶表面麻醉联合静脉麻醉用于无痛膀胱镜检查的有效性和安全性。

方法

本研究于2023年1月1日至2024年12月31日在北京清华长庚医院泌尿外科进行。根据预先设定的纳入和排除标准,共招募了60例符合条件的住院患者,并将其随机分为两组,每组30例。实验组接受盐酸丁卡因凝胶联合静脉麻醉,而对照组仅接受静脉麻醉。两组均缓慢静脉输注1.5mg/kg丙泊酚(1%)和0.15μg/kg瑞芬太尼。2分钟后,实验组经尿道给予10mL盐酸丁卡因凝胶,而对照组给予10mL甘油。4分钟后开始手术。在整个手术过程中,患者保持自主呼吸,必要时追加丙泊酚。记录两组患者的术前参数,包括丙泊酚用量、膀胱镜检查时间、麻醉/苏醒时间及相关生命体征。

结果

与对照组相比,实验组所需追加的丙泊酚明显更少,麻醉、膀胱镜检查及手术时间更短,术后SpO₂水平更高。两组均未观察到术后并发症或不良事件。

结论

盐酸丁卡因凝胶表面麻醉联合静脉麻醉在无痛膀胱镜检查中显示出显著优势,能有效减少丙泊酚追加用量,缩短检查时间,改善术后氧合,并确保高安全性。该方法具有相当的临床价值和广泛应用潜力。

临床试验注册

ChiCTR2300070527,注册日期:2023年4月14日。

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