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OBJECTIVE@#To verify the efficacy of transcutaneous electrical acupoint stimulation (TEAS) on catheter related bladder discomfort after ureteroscopic lithotripsy.@*METHODS@#Sixty male patients with selective ureteroscopic lithotripsy under general anesthesia were randomly divided into a TEAS group (30 cases, one case dropped off) and a sham TEAS group (30 cases, 2 cases dropped off). Before anesthesia induction, the patients in the TEAS group were treated with TEAS at Guanyuan (CV 4), Zhongji (CV 3), Zusanli (ST 36) and Sanyinjiao (SP 6) for 30 min, with disperse-dense wave, frequency of 2 Hz/ 15 Hz and current intensity of 6 to 10 mA. The patients in the sham TEAS group were treated with the same TEAS device at the same acupoints, but no electrical stimulation was given. After 30 min, anesthesia induction started. The total dosages of propofol and remifentanil in the two groups were recorded, and the time of operation and anesthesia, the time of wake-up and the time of stay in postanesthesia care unit (PACU) were recorded. The postoperative recovery was evaluated 5 min (T) after wake-up, 1 h (T), 2 h (T) and 6 h (T) after the operation, including the severity of urinary tract irritation and visual analogue scale (VAS) score. The occurrence of adverse reactions was observed, such as nausea and vomiting, dizziness and headache.@*RESULTS@#The dosage of remifentanil in the TEAS group was significantly lower than that in the sham TEAS group (0.05). Compared with the sham TEAS group, the incidence of more-than-moderate urinary tract irritation symptoms in the TEAS group was reduced (<0.05), and the VAS scores 1 and 2 h after operation were reduced (<0.05).@*CONCLUSION@#The 30-min TEAS at Guanyuan (CV 4), Zhongji (CV 3), Zusanli (ST 36) and Sanyinjiao (SP 6) before anesthesia induction could significantly control the severity of postoperative urinary tract irritation in patients with ureteroscopic lithotripsy, reduce the dosage of anesthetic drugs and relieve postoperative pain.
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Objective To investigate the preventive and therapeutic effects of different doses of penehyclidine hydrochloride preoperative medication on the catheter -related bladder discomfort during general anesthesia recovery period.Methods 160 adult patients who underwent general anesthesia for elective surgery were randomly dividided into four groups.40 patients in each group received intravenous injection 30min before surgery with penehyclidine hydrochloride 0.005mg/kg (group A),0.010mg/kg (group B),0.015mg/kg (group C),or normal saline (group D).All patients were catheterized with a 12 Fr Foley's catheter and the balloon was inflated with 8mL normal saline after anesthesia induction .The bladder discomfort was assessed during recovery in the post -anesthesia care unit .The severity of bladder discomfort was graded as mild , moderate and severe .Results The incidence of moderate and severe bladder discomfort in group B and group C (group B:20.0％,5.0％;group C:12.8％,2.5％) were significant lower compared with group A and group D ( group A:38.5％,12.8％;group D:46.0％ 15.4％) (χ2 =7.834, 6.764,8.163,14.172,8.362,6.943,15.413,17.512,all P<0.05).There was no significant difference between group B and group C , group A and group D .Conclusion Hydrochloride penehyclidine preoperative administration with 0.010mg/kg or 0.015mg/kg can effectively control the incidence of catheter discomfort during general anesthesia recovery period and 0.010mg/kg is appropriate for the elderly .
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Objective To compare the effects of tetracaine or lidocaine anesthesia effect on urethral agita-tion in thoracoscopic male patients during recovery period. Method One hundred and twenty male adults(18 ~60 yr),ASA physical status I and II undergoing elective thoracoscopic surgery ,were randomly divided into three groups of 30 cases in each one. The control group received paraffin oil lubrication catheterization after general anes-thesia induction,whereas the experimental groups received tetracaine gel or lidocaine gel 3~5 g in urethral surface anesthesia before catheterization. Intra-operatively ,urinary catherization was performed with a 16 Fr Foley′s cathe-ter,and a balloon was inflated with 10 mL distilled water. The CRBD was assessed at 0,1,and 12 h after patient′s arrival in the post-anaesthesia care unit. Severity of CRBD was graded as none,mild,moderate and severe. Data were analysed by one-way ANOVA and Fisher′s exact test. P < 0.05 was considered significant. Results Inci-dence and severity of CRBD was reduced in the experimental groups compared with the control group(P < 0.05). Postoperative pain as assessed by visual analogue scale and Richer-SAS was also reduced in the experimental group compared with the control group. Furthermore,in the tetracaine group,catheter-related complaint had less discom-fort than that in the lidocaine group. Conclusion Lidocaine and tetracaine surface anesthesia can significantly reduce catheter-related bladder discomfort after induction ,and tetracaine mucilage lasts for a longer time and less discomfort.
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Objective To explore the effect of compound lidocaine cream and/or psychotherapy in preventing the catheter-related bladder discomfort (CRBD) of male patients with operation under general anesthesia. Methods Eighty male patients undergoing selective upper abdomen operation were selected, and the patients were divided into 4 groups by random digits table method with 20 cases each:control group (C group), compound lidocaine cream group (L group), psychotherapy group (B group) and compound lidocaine cream combined with psychotherapy group (LB group). The incidence of CRBD after extubation, dosage of fentanyl and the number of patients who need flurbiprofen axetil to relief the pain of CRBD were compared among the 4 groups. Results The incidence of no CRBD after operation in LB group was significantly higher than that in C, L and B group: 90%(18/20) vs. 15%(3/20), 60%(12/20) and 50% (10/20), and there were statistical differences (P0.05). The rate of patients who need flurbiprofen axetil to relief the pain of CRBD in C group was significantly higher than that in L, B and LB group: 40%(8/20) vs. 5%(1/20), 10%(2/20) and 0, and there were statistical differences (P<0.05). Conclusions Both the means of compound lidocaine cream and psychotherapy can reduce the incidence of CRBD. However, the method of compound lidocaine cream combined with psychotherapy is able to basically avoid the occurrence of CRBD, and it is worth spreading in clinic.
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Objective To determine whether a prophylactic tolterodine administration before surgical operation on non-urologic patients under general aneathesia can prevent the occurrence of catheter-related bladder discomfort (CRBD) ; and to assess patients’ tolerance to the symptoms as well as the impact on related consultation work of urologic surgeons.Methods One hundred and eighty cases of non-urology patients who need general aneathesia operations were divided into 2 groups:90 cases in tolterodine group and 90 in control group.The assessment of CRBD is categorized into 4 steps and statistics for adverse events ( dry mouth,dizzyness and facial flushing) was also conducted.A record of the patients’ needs for urologic surgical consultation during their reservation of catheter was also kept.SPSS 13.0 used in the statistical analysis of data in terms of X2 examination,where the divergence P ＜ 0.05 was regarded statisticly valid.Results 82 cases were followed up in the tolterodine group with a 24.4％ CRBD occurrence,which included 7.2％ shows moderate and severe symptoms,and there were also 23 cases with dry mouth ( 28.0％ ),4 cases with dizzyness (4.8％),13 cases with facial flussing ( 15.8％ ),and 1 case who needs further consultation (1.2％).In the 86 followed-up cases in control group,CRBD occurance rate was 54.7％,with 30.2％ showed moderate and severe symptoms,plus 2 cases suffered from severe consequences.Nine cases ( 10.5％) in control group requires further consultation ( X2 =19.499,P =0.000 ＜ 0.05 ).Conclusions A prophylactic tolterodine administration before surgery to the patients underwent general aneathesia can prevent the occurrence ofcatheter-related bladder discomfort (CRBD) and reduce the consultation work of urologic surgeons.Patients using tolterodine show a higher rate of adverse events,yet to which most patients can tolerate.
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Objective:To compare the efficacy of penehyclidine hydrochloride and atropine in the prevention of catheter related bladder discomfort(CRBD) in patients undergoing gynecology laparoscopic surgery.Method;Eighty ASA classⅠorⅡpatients undergoing elective gynecology laparoscopic surgery were randomly assigned into 2 groups of P and A with 40 cases each.Fifteen minutes before the anesthesia induction,penehyclidine hydrochloride 0.5 mg and atropine 0.25 mg were administered in Group P and Group A,respectively.After the induction of anesthesia,patients were catherized with a 14 Fr Foley's catheter.HR,bladder discomfort,Ramsay Sedative Score(RSS) and side reactions were recorded at 0 h,0.5 h,1 h and 6 h after the end of surgery in the post-anaesthesia care unit(PACU).The severity of bladder discomfort was graded as mild,moderate and severe.Result:The total incidence rate of CRBD in Group P was apparently lower than that in Group A(P0.05).The incidence rate of CRBD of Group P was apparently lower than that in Group A at 6 h after the end of surgery(P0.05).Conclusion:The application of enehyclidine hydrochloride before anesthesia induction provides a better prophylactic effect of CRBD than that of atropine but with a higher incidence rate of dry mouth.
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OBJECTIVE: To evaluate the effect of butorphanol on postoperative catheter-related bladder discomfort(CRBD).METHODS: Sixty male cases(ASA grade Ⅰ～Ⅱ) undergoing epigastric surgery were randomly assigned to receive Butorphanol injection(n=30,trial group) or same volume of normal saline(n=30,control group) 45 min before the withdrawal of tracheal catheter.The prophylactic and analgesic effect of butorphanol on CRBD as well the adverse drug reactions such as nausea & vomiting,and dry mouth were observed.RESULTS: Both the incidence and severity of CRBD were lower in the trial group than in control group at each time point(P