Clinical trial of chloropropane hydrochloride combined with bupivacaine in the treatment of patients with urinary retention after elective mixed hemorrhoids resection
10.13699/j.cnki.1001-6821.2023.24.012
- VernacularTitle:盐酸氯普鲁卡因联合布比卡因治疗择期混合痔切除术后尿潴留患者的临床研究
- Author:
Xian-Long HAN
1
;
Min PU
;
Xin SU
;
Xin XI
;
Feng LIANG
Author Information
1. 青岛市中医医院、市海慈医院、青岛大学附属青岛市海慈医院肛肠科,山东青岛 266033
- Keywords:
mixed hemorrhoids;
bupivacaine;
chloropropane;
urinary retention;
sequential analysis;
subarachnoid nerve block
- From:
The Chinese Journal of Clinical Pharmacology
2023;39(24):3598-3602
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the optimal amount of chloropropane combined with low-dose bupivacaine during elective mixed hemorrhoidectomy and to observe the incidence of urinary retention under the combined anesthetic regimen.Methods Prospectively recruited patients with mixed hemorrhoids,L3-L5 subarachnoid nerve block anesthesia was used,the first patient was experimentally applied 3％chloropropane hydrochloride injection 3.0 mL slowly pushed in,after 5 min observation,3％chloropropane hydrochloride 6.0 mL was formally injected,when the visual analogue scale(VAS)was ≤2,the second patient had 1/6 probability of receiving a lower dose(1.0 mL decrease)or 5/6 probability of maintaining the current dose;when the VAS score was＞2,the second case had a 1/6 probability of receiving a higher dose(1.0 mL increase)or a 5/6 probability of maintaining the current dose.The 90％effective dose(ED90)value of chloropropane hydrochloride,the incidence of postoperative urinary retention,the saved dose of chloropropane hydrochloride,the VAS score of analgesic effect within 15 d after surgery,and the safety evaluation.Isotonic regression equation was used to calculate the ED90,95％confidence interval for chloroprocaine hydrochloride.Results The overall incidence of postoperative urinary retention was 19.18％(14 cases/73 cases),incidence of urinary retention between the initial dosage groups possessed statistical differences(P＜0.05).The incidence of urinary retention were 57.14％,0 and 42.86％in 8.0-13.0 mL,14.0-16.0 mL and 17.0-18.0 mL groups,respectively;compared with the population without urinary retention in the same dose group,the 14.0-16.0 mL and 17.0-18.0 mL had statistical difference(P＜0.05),8.0-13.0 mL group did not have statistical difference(P＞0.05).The mean salvage dose was(13.44±1.57)mL,and no significant linear trend was seen in the salvage dose of chloropropane hydrochloride with increasing initial dose(P＞0.05).The VAS scores at 0,4,12 and 24 h postoperatively were 1.55±0.90,6.55±0.44,2.95±0.93 and 1.78±0.69,respectively;a linear decreasing trend in VAS scores was observed in the 4-24 h postoperative period(P＞0.05).The overall incidence of adverse drug reactions was 16.44％(12 cases/73 cases).Conclusion ED90 of chloropropane hydrochloride combined with low-dose bupivacaine anesthesia in L3-L5 subarachnoid nerve block anesthesia for mixed hemorrhoids surgery was 11.76 mL.The combined anesthesia scheme can reduce the incidence of postoperative urinary retention and the total dose of anesthesia rescue.The incidence of adverse drug reactions is low and has certain clinical safety.
