摘要
Abstract
Objective To investigate the effects of low-dose esketamine on catheter-related bladder discomfort(CRBD)in elderly male patients after ureteroscopic lithotripsy(URL).Methods 90 elderly male patients with URL from October 2023 to Jun 2024 were selected and randomly divided into group A(esketamine group)and group B(control group),45 cases in each.After induction of general anesthesia,group A received intravenous infusion of 0.15 mg/kg esketamine hydrochloride diluted with saline to 10 mL,while group B received an equal volume of saline.The occurrence and severity of CRBD were recorded at T0(immediately after catheter removal),T1(30 min after catheter removal),T2(2 h after catheter removal),and T3(6 h after catheter removal)time points.The neurocognitive status and the incidence of perioperative neurocognitive disorder(PND)were assessed using the mini-mental state examination(MMSE)score one day before surgery and 6 h after surgery.Relevant indicators during the perioperative period and in the postanesthesia care unit(PACU)observation period were recorded for both groups.Results There were no statistically significant differences in anesthesia duration,recovery time,dosages of propofol and remifentanil between the two groups(P>0.05).Compared with group B,group A showed significantly lower CRBD incidence rate at T0,T1,T2 and T3 time points,and the severity rate of CRBD at T0,and T1 time points in group A was significantly lower than that in group B,the differences were statistically significant(P<0.05).Group A also had higher MMSE scores and lower PND incidence rate 6 h after surgery compared to group B,the differences were statistically significant(P<0.05).Compared with group B,group A required fewer tramadol hydrochloride administrations at T0,exhibited higher Ramsay sedation scale(RASS)scores,and lower Visual analog the scale(VAS)scores and Richer agitation-sedation Scale(SAS)scores,the differences were statistically significant(P<0.05).No adverse reactions were observed in either group after surgery.Conclusion Low-dose esketamine can effectively reduce the incidence and severity of early CRBD in elderly male patients after URL,which may be related to its minimal impact on postoperative cognitive function and better sedative and analgesic effects.关键词
艾司氯胺酮/老年男性/导尿管相关膀胱刺激征(CRBD)/全身麻醉/导尿管/认知功能Key words
esketamine/elderly males/catheter-related bladder discomfort(CRBD)/general anesthesia/urinary catheter/cognitive function分类
医药卫生
