Effect of low dose esketamine on urethral bladder irritation in patients undergoing laparoscopic radical resection of rectal cancer
Objective To investigate the anesthetic effects of low-dose esketamine in laparoscopic radical resection of rectal cancer and the preventive effects of catheter-related bladder discomfort(CRBD)during convalescence.Methods A total of 260 male patients who underwent laparoscopic radical resection for rectal cancer from January 2020 to September 2023 were selected,all of whom underwent general anesthesia with tracheal intubation.The patients were divided into study group and control group by simple randomization,with 130 cases in each group.After anesthesia induction,the study group was given 0.2mg/kg esketamine before catheter insertion,while the control group was given 0.9％sodium chloride injection at the same dose,the induction and maintenance of anesthesia were the same in both groups.The incidence and severity of CRBD immediately after trachea extubation(T0),10 min(T1),30 min(T2),1h(T3)and 4 h(T4)were observed in both groups,and the total incidence and severity of CRBD in the two groups within 4 h of extubation were analyzed.The hemodynamic indexes,Ramsay sedation score and visual analogue scale(VAS)pain score were observed at each time period.Postoperative complications and adverse reactions were compared between the two groups.Results At T0 and T1,the incidence of CRBD in study group was significantly lower than that in control group(P＜0.05).The total incidence of CRBD in the study group was significantly lower than that in the control group(43.08％vs 64.62％,P＜0.05).The incidence of moderate to severe CRBD in the study group was lower than that in the control group(19.2％vs 46.9％,P＜0.05).Compared with T0,the heart rate and mean arterial pressure of T2-T4 in both groups were significantly decreased(P＜0.05).Compared with the control group,the Ramsay sedation score at T1-T4 were higher in the study group,and the VAS pain score at T3-T4 were lower(P＜0.05).Compared with T0,T1-T2 Ramsay sedation score were gradually increased(P＜0.05),T3-T4 Ramsay sedation score were gradually decreased,and VAS pain score were gradually increased in both groups(P＜0.05).There was no significant difference in complications and adverse reactions between the two groups(P＞0.05).Conclusion Low-dose esketamine can effectively reduce the incidence and severity of CRBD in patients undergoing laparoscopic radical resection of rectal cancer during anesthesia recovery,with good analgesic and sedative effects,without increasing the risk of complications.
laparoscopic radical resection of rectal canceresketamineanesthesia recovery periodcatheter-related bladder discomfort
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