|
|
|
| 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.
|
|
Received: 19 July 2018
|
|
|
|
|
|
[1] 于祥征,林雪莉.微通道与标准通道经皮肾镜碎石术对肾结石患者血流动力学和血气分析的影响[J].中国基层医药,2016,23(16):2525-2529.
[2] 程跃,谢国海,严泽军,等.逆行输尿管软镜联合可视微通道经皮肾镜一期治疗鹿角形肾结石的临床分析[J].中华泌尿外科杂志,2016,7(2):127-130.
[3] 刘磊,刘经纬,彭思维,等.超声引导下胸椎旁神经阻滞与腰硬联合麻醉在经皮肾镜碎石术中的临床疗效比较[J].临床外科杂志,2017,25(10):785-787.
[4] 李茂胤,王德娟,黄文涛,等.无管化经皮肾镜碎石取石术治疗鹿角形肾结石[J].中华腔镜泌尿外科杂志(电子版),2016,10(1):36-39.
[5] 胡春欢,刘书宇,柴方圆,等.全麻与椎管内麻醉对经皮肾镜下肾结石手术的影响差异分析[J].中国现代医生,2017,55(4):122-124.
[6] 李鑫,宋波,孔广起,等.组合式输尿管软镜联合钬激光治疗肾及输尿管上段结石97例报告[J].中国微创外科杂志,2016,16(7):621-623.
[7] Kose HC, Kose SG, Thomas DT.Lumbar versus thoracic erector spinae plane block: Similar nomenclature, different mechanism of action[J].J Clin Anesth,2018, 21(48):1-9.
[8] 郭尔萍,刘磊,董家才,等.胸椎旁神经阻滞复合尿道黏膜麻醉在经皮肾镜手术中的应用[J].中国继续医学教育,2018,10(11):61-63.
[9] Aydin G. Unexpected local anesthesia toxicity during the ultrasonography-guided peripheral nerve block[J].J Clin Anesth,2018, 15(50):26-28.
[10] 马力,张学能,李英,等.不同导尿时机对老年手术患者尿道黏膜损伤、膀胱刺激征及血流动力学影响[J].国际泌尿系统杂志,2017,37(4):532-536. |
|
|
|
2020, Vol. 37 
