Effect of Thoracic Paravertebral Nerve Block Combined with Urethral Mucosal Anesthesia on Urethral and Bladder Irritation in Patients with Urethral Catheterization
HAO Xiao-yan
Dalian Friendship Hospital Liaoning Province 116001
Abstract：【Objective】To explore the value of ultrasound-guided thoracic paravertebral nerve block anesthesia (PVB) combined with urethral mucosal anesthesia in patients with renal calculi undergoing transurethral catheterization.【Methods】A total of 140 patients with kidney stones were randomly divided into group A and group B with 70 cases in each group. Patients in both groups received percutaneous nerve lithotripsy. Group A used ultrasound-guided PVB combined with urethral mucosal anesthesia, while group B used ultrasound-guided PVB only. The heart rate (HR) and mean arterial pressure (MAP) were compared between the two groups of patients before anesthesia (T0), 10 minutes after anesthesia (T1), after the establishment of a lithotripsy (T2), during lithotripsy (T3) and end of surgery (T4). Meanwhile, the degree of bladder irritation, postoperative hematuria and the incidence of various adverse reactions were recorded and compared during the intraoperative urethral catheterization. 【Results】At T0, T3 and T4, the HR values were not statistically significant difference between group A and group B (P>0.05). At T1 and T2, the HR values of group A were higher than those of group B (P<0.05). At T0 and T4, the difference of MAP between group A and group B was not statistically significant (P>0.05). At the time of T1, T2 and T3, the MAP value of group A was higher than that of group B (P<0.05). The incidence of bladder irritation during urethral catheterization in group A was lower in group than that in group B (P<0.05). The incidence of postoperative hematuria in group A was 31.43%, which was lower than that in group B (47.14%); the difference was statistically significant (P<0.05). The incidence of adverse reactions in group A was lower than that in group B (P<0.05).【Conclusion】Ultrasound-guided PVB combined with urethral mucosal anesthesia in patients with renal calculi undergoing transurethral catheterization is beneficial to reduce the irritating effect on the urethra and bladder of patients, maintain the stability of blood flow during surgery, and reduce various adverse reactions after operation.
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2020, Vol. 37 
