The Effect Of The Penehyclidine Hydrochloride On Bladder Spasm After Transurethral Resection Of Bladder Tumor

Objective To observe the effect of the penehyclidine hydrochloride (PHC) on bladder spasm after transurethral resection of bladder tumor (TURBT).Method Sixty patients with bladder tumor undergoing TURBT under balanced anesthesia whose age was between forty to sixty-five, whose American Society of Anesthesiolgists classification was â…  or â…¡, and whose body mass index was between eighteen point five to twenty-four kilogram per square meters, were randomly divided into two groups (with thirthy patients in each group):treatment group and conrtol group. Intramuscular injection of penehyclidine hydrochloride was used in operation in treatment group. Control group were only given tolterodine.Each patient was injected phenobarbital sodium zero point one gram and scopolamine zero point three milligram thirty minutes before the surgery intramuscularly. After patients entering the operating room, venous puncture of upper limbs was done and then the lactated Ringer injection was dripped. Blood pressure, electrocardiogram, pulse oxygen saturation, and so on, were monitered, and their basic value was recorded. Anesthesia induction was parried out in lithotomy position. Fentanyl citrate, of which the dose was one microgram per kilogram, and propofol, of which the dose was one to one point five milligram per kilogram, were injected by intravenous. After consciousness of patients disappeared, intramuscular injection of penehyclidine hydrochloride, of which the dose was-eight microgram per kilogram, and which was diluted to two milliliters, was used in operation in treatment group. Control group were only given tolterodine of equal volume. Before the surgery started, fentanyl citrate, of which the dose was one microgram per kilogram, was injected by intraveous once more. During operation, propofol, of which the dose was five to seven miligram per kiolgram, was pumped into the vein persistently. And the dose of propofol could be changed according to hemodynamic and surgery situation. When surgery was finished, the use of propofol was stopped.On one hand, we should observe and record heart rate, mean arterial blood pressure and pulse oxygen saturation at the momment of patients entering the operating room (To), before induction (T1), after induction and before penehyclidine hydrochloride or tolterodine was injected (T2), the beginning of the surgery (T3), thirty minutes after penehyclidine hydrochloride or tolterodine was injected (T4), the end of the surgery (T5), before patients leaving the operating room (T6). Also, the complication in resporatory system, circulatory system and so on during and after the operation, and the duration of surgery should be recorded. The measures against the complication should also be observed and recorded. On the other hand, the follow-up visiting to patients should be carried out respectively two hours after operation, four hours after operation, six hours after operation, and twenty-four hours after operation. And then the incidence times of bladder spasm, the visual analogue scale (VAS), adverse reaction such as dry mouth and dizziness, measures of analgesia after the surgery were recorded.Results General situation and operating time of patients in two groups were little different from each other statistically (P>0.05). So were heart rate, mean arterial blood pressure and pulse oxygen saturation at the momment from To to T6(P>0.05). In each group, heart rate and mean arterial blood pressure from T2to T5were lower than that of To (P<0.05), and heart rate and mean arterial blood pressure of T1and T6were little different from each other statistically (P>0.05). The average incidence time per hour of bladder spasm of treatment group were less than that of control (P<0.05), the visual analogue scale of treatment less than that of control (P<0.05),and the requirement of other analgesics less than that of control (P<0.05). Serious adverse reaction were not found in each group both during and after the operation.Conclusion The inciderce times of bladder spasm of patients after transurethral resection of bladder tumor was lessened, the visual analogue scale degraded, and the requirement of other analgesics reduced through intramuscular injection of the penehyclidine hydrochloride, of which the dose was eight microgram per kilogram, in the operation.