Effect of dexmedetomidine combined with dyclocainemucilage analgesia on the incidence rate of postoperative catheter related bladder discomfort after general anesthesia

Objective To investigate the effects of dexmedetomidine combined with dyclonine mucilage analgesia on the incidence rate of postoperative catheter related bladder discomfort(CRBD) after general anesthesia.

Methods A total of 90 male patients with general anesthesia were divided into the dexmedetomidine group(group D), dexmedetomidine combined with dclonine mucilage(group DD) and control group(group C) according to the random number table method(30 cases each group). Before induction of anesthesia, the 1.0 μg/kg dexmedetomidine was intravenously injected into the group D and group DD. After induction, the vulva and urethral orifice in the group DD were routinely disinfected, and the 5 mL dacronine glue was injected into the group DD through the urethra for analgesia, and 2 mL dacronine glue was evenly smeared on the urethra for lubrication. The group C were treated with equal amount of 0.9% sodium chloride solution for routine urethral catheterization. The changes of hemodynamic indexes, agitation score(RS score), Ramsay sedation score, anesthesia recovery time and incidence rate and degree of postoperative CRBD in three groups were observed and compared before anesthesia induction(T₀), before extubation(T₁), during extubation(T₂) and after 15 min of extubation(T₃).

Results Compared with T₀, the systolic blood pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR) in the group C at T₁, T₂ and T₃ significantly increased(P < 0.05), the SBP, DBP and HR in group D at T₁ and T₂ significantly increased(P < 0.05), while there were not significant changes in the group DD(P>0.05).Compared with the group C, the SBP and HR at T₂ and T₃, and DBP at T₂ in the group D were lower(P < 0.05), and the SBP and HR at T₁, T₂ and T₃, and DBP at T₂ in the group DD were lower(P < 0.05).Compared with the group D, the SBP in the group DD at T₁ and T₂ were lower(P < 0.05), and there was no significant difference in the rest(P>0.05).Compared with the T₀, the RS score and Ramsay sedation score in the group D and DD at T₁, T₂ and T₃ were significantly decreased(P < 0.05), while there were not significant changes in group C(P>0.05).Compared with the group C, the RS scores were lower(P < 0.05), and the Ramsay sedation scores were higher in the group D and group DD at each time point(P < 0.05).Compared with the group D, the differences of the RS scores in group DD among all time points were not statistically significant(P>0.05), and the Ramsay sedation scores at all time points except T₀ were higher(P < 0.05).The differences of the respiratory recovery time, recovery time and extubation time among three groups were not statistrically significant(P>0.05).Compared with the group C, the incidence rate of postoperative CRBD in group D and group DD were lower(P < 0.01), and the degree of CRBD was less(P < 0.01).Compared with the group D, the incidence rate of postoperative CRBD in group DD was lower(P < 0.01), and the degree of CRBD was milder(P < 0.01).

Conclusions The dexmedetomidine combined with dyclonine mucilage analgesia can effectively inhibit the nerve impulses of patients with general anesthesia in the department of urology, reduce the local adverse stimulation, make hemodynamic parameters more stable in the process of anesthesia, relieve the degree of agitation and suffering of patients, effectively prevent the CRBD, reduce the level of the CRBD and increase the comfort and safety of urethral catheterization.