Effects Of Different Doses Of Dexmedetomidine On Preventing Catheter-related Bladder Discomfort

Background: At Present,everyone is advocating comfortable medical treatment,and routine Preo Perative treatment of indwelling urethral catheter has been adjusted to be Performed after induction of general anesthesia.Perha Ps because the Patient is unconscious after a general anesthetic,they do not remember what it feels like to have a tube inserted into the urethra.When Patients wake u P from anesthesia,the stimulation of the urinary duct can make them feel abnormal and can even cause bladder irritation.Clinically,what we call catheter related bladder excitement(CRBD)occurs when Patients ex Press a desire to urinate and may be accom Panied by limb swings or even attem Pts to Pull out their catheters.This sym Ptom may occur in the vast majority of Patients with urethral catheterization after general anesthesia.It will not only make Patients agitated,but also induce cardiovascular system diseases such as hy Pertension,myocardial insufficiency,arrhythmia and heart failure,and even cause incision dehection and bleeding during surgery.CRBD will cause slow Posto Perative recovery of Patients,affect the time of discharge,increase the cost of Patients,and also lead to the decline of hos Pital bed turnover.Therefore,we should Pay attention to the Prevention of CRBD.Objective:1、The incidence and severity of cathetery-related bladder irritation in TURP Patients were com Pared after intravenous administration of different doses of dexmedetomidine 30 minutes before catheter Placement by the surgeon;2、The sedation and analgesia intensity of different doses of dexmedetomidine for TURP Patients after general anesthesia and the number of Patients with various side effects were com Pared.Methods: This test has been made,with the a PProval of the hos Pital’s ethics committee and signed with the Patients informed consent,choose between January 2019 and December 2020,our hos Pital this time choose the intravenous anesthesia downlink TURP,between the ages of 60-85 age,ASA class for Ⅰ-Ⅱ of 120 cases of elderly male Patients.Thirty minutes before the surgeon Placed the catheter,the researchers assigned the subjects to three grouPs of 40 using a random number table.The first grouP(D1)received 0.5μg/kg of dexmedetomidine,the second grouP(D2)received 1μg/kg of dexmedetomidine,and the third grouP(C)received normal saline.Choose between65-85-year-old elderly male Patients undergoing elective im Plementation of TURP under general anesthesia,ASA Ⅰ-Ⅱ level,between 60 and 85 kg weight,o Peration time is 60-120 min,and record after the anesthesia o Pen time and Pull out a laryngeal mask,Pull out a laryngeal mask instantly CRBD ratings,and Pulls out a laryngeal mask immediately,1 hour,2 hours,4 hours of Visual analog Pain(Visual Analogue Scale,VAS)a grade,the degree of sedation(Ramsay);When the CRBD score was greater than2 Points,it indicated the Presence of moderate to severe CRBD.We treated the sym Ptoms of CRBD with intravenous oxycodone,and we also recorded Patients with delayed wakening,significant blood Pressure reduction,and bradycardia.Results: A total of 124 Patients who met the criteria were selected for the study.Exce Pt for 1 Patient who refused to Partici Pate in the study after ex Plaining the cautions,the remaining 123 Patients agreed to Partici Pate in the study,with 41 Patients in each grouP.During the data collection Process,one Patient in GrouP C changed the method of anesthesia,one Patient in GrouP D1 had incom Plete data collection,and one Patient in GrouP D2 changed the method of surgery.Finally,40 Patients in each grouP com Pleted the trial.1、Com Parison of the general conditions of the three grouPs After observation,the consciousness of Patients in D1 grouP was recovered more quickly than that in D2 grouP,and the difference was statistically significant(P<0.05).However,there was no significant difference in the general condition of the three grouPs,the time of o Peration and the time of eye o Pening(P>0.05).2、Com Parison of CRBD scores in the three grouPs D1 and D2 grouP the incidence of catheter related bladder irritation were 32.5% and30%,significantly less than 70% of the grouP C(P < 0.05),D1 and D2 grouP relation between the incidence of CRBD is 7.5%,and even u P to 30% of grouP C(P < 0.05),D1 CRBD score with D2 grouP com Parison,the difference between the two grouPs have no statistical significance(P > 0.05).3、Com Parison of VAS scores in three grouPs Com Pared with grouP C,VAS scores of D1 and D2 grouPs were significantly decreased immediately,1 hour,2 hour and 4 hours after laryngeal mask removal(P<0.05),while there was no significant difference in VAS scores between D1 and D2 grouPs(P>0.05).4、Com Parison of Ramsay sedation scores of three grouPs of Patients Com Pared with grouP C,the Ramsay scores of D1 and D2 grouPs immediately after the laryngeal masking was removed were statistically different(P<0.05),but no difference was observed in the sedation scores of D1 and D2 grouPs(P > 0.05).There was no significant difference in the Patients’ agitation at the time Points of 1,2 and 4 in the three grouPs(P > 0.05).5、The number of Patients with delayed Posto Perative awakening was 1 case in GrouP C,2 cases in GrouP D1,and 7 cases in GrouP D2.It can be observed that,com Pared with GrouP C and GrouP D1,the number of Patients with slow recovery of consciousness in GrouP D2 was significantly increased(P<0.05).The number of Patients with decreased blood Pressure after o Peration was 0 in grouP C,1 in grouP D1 and 1 in grouP D2.The number of Patients with slow heart rate was 0 in grouP C,1 in grouP D1 and 2 in grouP D2.There was no statistical significance in the occurrence of various adverse reactions among the three grouPs(P > 0.05).Conclusion:1、Reasonable dose of dexmedetomidine a PPlied 30 minutes before catheter Placement can significantly relieve bladder irritation sym Ptoms caused by catheter in TURP Patients after anesthesia recovery;2、The a PPlication of 0.5μg/kg dexmedetomidine 30 minutes before the insertion of the catheter by the surgeon can effectively reduce the degree of Pain in TURP Patients after withdrawal,moderate sedation,and the incidence of delayed Posto Perative recovery is lower in elderly Patients com Pared with 1μg/kg dose.