The Effectiveness Of Penehyclidine And Glycopyrrolate For Catheter-related Bladder Discomfor After General Anesthesia In Male Patients With Upper Abdominal Surgery

Objective : The effectiveness of penehyclidine and glycopyrrolate for catheter-related bladder discomfort(CRBD)in male patients with upper abdominal surgery under general anesthesia.Method:Ninety male patients undergoing elective upper abdominal surgery were selected and randomly divided into three groups: 30 patients in each group.In group P,10μg / kg penehyclidine was diluted to 5m L using 0.9% normal saline and injected intravenously;In group G,4 μg / kg of gronium bromide was given after dilution of the same method;in Group C,5 m L of 0.9% sodium chloride solution was injected intravenously.All three groups retained urinary catheter after induction of anesthesia,observed the incidence of intraoperative tachycardia,10min(T1),1h(T2),3h(T3),6 h(T4)bladder stimulation symptom severity score,agitation score,incidence of adverse reactions,including postoperative cognitive dysfunction(POCD),postoperative nausea and vomiting(PONV),dry mouth,flushing,blurred vision,and patient satisfaction score after surgery 6h.Results :(1)There were no significant differences in age,ASA grade,BMI,education,type of surgery,surgery time,extubation time,and intraoperative sufentanil dosage among the three groups(P> 0.05).(2)The incidence of CRBD in group P and G was lower at time T1-T4 than group C,the rate of CRBD severity(moderate to severe)in group P at time T1-T4 was lower than group C;the severity rate of CRBD in group G at time T1-T3 was lower than in group C,but the severity rate of CRBD at time T4 was slightly higher than in group C.The overall incidence of CRBD in the three groups was 46.67%,including 40% in P,33.33% in G and 66.67% in C,with significant differences in the overall incidence of CRBD in the three groups(P <0.05).(3)The incidence of intraoperative tachycardia in group G was 33.33%,which was significantly higher than 10% in group P and 6.67% in group C,there was significant difference in the incidence of intraoperative tachycardia among the three groups(P<0.05).(4)Groups P and G had lower agitation scores at different time points than C,and the overall distribution of agitation scores at time T1 had significant difference among the three groups(P <0.05).(5)The degree of satisfaction after surgery 6h in Group P was 76.67%,in Group G was 73.33%,in Group C was 46.67%,there was significant statistical difference in the three groups(P <0.05).(6)No patients with POCD,flushing or blurred vision were observed in the three groups,and the incidence of postoperative xerostomia was higher in group P than that in group C and group G,and the incidence of postoperative xerostomia was statistically different(P <0.05).There was no significant difference in the incidence of PONV among the three groups(P>0.05).(7)There was no statistical difference between the age of CRBD(P> 0.05),and the education had statistical difference between CRBD and no CRBD(P <0.05).Conclusion:Intravenous injection of penehyclidine 10μg / kg or glycopyrrolate4 μ g/kg during the induction of anesthesia in male upper abdominal surgery can effectively reduce the occurrence of CRBD during the recovery period of general anesthesia,reduce its severity,and improve patient’s postoperative satisfaction,but in the longer time surgery,penehyclidine’s prevention effect is better than glycopyrrolate.