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Taylor Z, Snow Z, Musallam S, Thomas B, Zeltser I. Is Urethral Catheterization Necessary in Retzius-sparing Robot-assisted Radical Prostatectomy? Urology 2023; 182:133-135. [PMID: 37742850 DOI: 10.1016/j.urology.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/03/2023] [Accepted: 09/12/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE To analyze whether urethral catheter (UC)-free anastomosis during Retzius-sparing radical prostatectomy (RP) results in worsening immediate perioperative and postoperative complications. METHODS We retrospectively reviewed records of patients undergoing robotic-assisted RP with or without indwelling UC placement by a single surgeon between January 2020 and March 2022. Clinical and pathological characteristics were evaluated. An independent t-test was used to compare continuous variables, and Pearson's chi-square test or Fisher exact test was used to compare categorical variables. RESULTS One hundred fifteen patients underwent robotic prostatectomy from January 2020 to June 2022. Sixty-two patients had both a UC for 12 hours postoperatively and a suprapubic catheter for 6days, while in 53 patients a UC was omitted. There was no significant difference noted between the groups regarding age, body mass index, American Society of Anesthesiology score, prostate-specific antigen, stage, node status, or positive margins. There were no significant differences in the rates of anastomotic leak, ileus, or urethral stricture. Patients had a significantly higher pad-free rate in the suprapubic catheter-only group (P = .04) at 3months. There was no difference in average number of pads used or the number using more than 1 pad/day. CONCLUSION Omission of urethral catheterization during Retzius-sparing RP is safe and doesn't result in an increased risk in perioperative or postoperative complications, but rather appears to be associated with a significantly improved 3-month pad-free rate.
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Affiliation(s)
| | - Zachary Snow
- Main Line Health System, MidLantic Urology, Wynnewood, PA
| | - Sami Musallam
- Main Line Health System, MidLantic Urology, Wynnewood, PA
| | - Brian Thomas
- Main Line Health System, MidLantic Urology, Wynnewood, PA
| | - Ilia Zeltser
- Main Line Health System, MidLantic Urology, Wynnewood, PA
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2
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Huang HS, Fang HY. Effects of Artificial Intelligence on Surgical Patients' Health Education. Healthcare (Basel) 2023; 11:2705. [PMID: 37893779 PMCID: PMC10606014 DOI: 10.3390/healthcare11202705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/27/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Today, the various abilities that nurses require to meet patients' healthcare needs adequately are all affected by AI-enabled systems. This research used an experimental study design in which 60 subjects were randomly assigned to either an experimental (AI image e-book guidance) group or a control (text paper guidance) group after meeting the admission conditions and agreeing to participate in the study. It was proven that providing AI image e-book guidance before surgery significantly changed the behavior of patients and promoted relief of urinary catheter discomfort through self-efficacy to reduce urinary catheter pain after surgery (p < 0.001). It was found that providing AI image e-book guidance can shorten the time for health education and provide patients with repeated medical education and familiarity with health guidance, which can help to address the important clinical service demand issue and the shortage of nursing staff.
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Affiliation(s)
- Hsin-Shu Huang
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung 40601, Taiwan
| | - Hsin-Yuan Fang
- Department of Surgery, China Medical University Hospital, Taichung 40447, Taiwan
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3
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Liao X, Xie M, Li S, Yu X. Comparison of tramadol and lornoxicam for the prevention of postoperative catheter-related bladder discomfort: a randomized controlled trial. Perioper Med (Lond) 2023; 12:27. [PMID: 37337277 DOI: 10.1186/s13741-023-00317-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 06/11/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Catheter-related bladder discomfort (CRBD is a painful complication of intraoperative urinary catheterization after anaesthesia. We conducted this study to compare the effect of tramadol and lornoxicam for the prevention of postoperative CRBD. METHODS One-hundred twenty patients (aged 18-60 years, ASA physical status 1-2, undergoing elective uterine surgery requiring intraoperative urinary catheterization were randomly divided into three groups with 40 patients in each group. Group T received 1.5 mg/kg tramadol, group L received 8-mg lornoxicam, and group C received normal saline. The study drugs were administered intravenously at the end of the surgery. The incidence and severity of CRBD were reported at 0, 1, 2, and 6 h after arrival at the postanaesthesia care unit (PACU). RESULTS The incidence of CRBD was significantly lower in groups T and L than in group C at 1, 2, and 6 h after surgery. The incidence of moderate to severe CRBD was also significantly lower in groups T and L than in group C at 0, 1, and 2 h after surgery. The severity of CRBD reported as mild, moderate, and severe was reduced in groups T and L compared with group C at most times after surgery. Group T had a higher incidence of nausea than group C, and there were no differences in dizziness, drowsiness, or vomit among the three groups. CONCLUSIONS Tramadol and lornoxicam administered intravenously at the end of the surgery were both effective in preventing the incidence and severity of CRBD after uterine surgery. However, tramadol increased the incidence of nausea compared with saline, but there was no difference between tramadol and lornoxicam. TRIAL REGISTRATION ChiCTR2100052003. Registered on 12/10/2021.
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Affiliation(s)
- Xin Liao
- Department of Operation Room, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital of Sichuan University, Sichuan Province, Chengdu, China
| | - Min Xie
- Department of Operation Room, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital of Sichuan University, Sichuan Province, Chengdu, China
| | - Shuying Li
- Department of Anesthesiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital of Sichuan University, Sichuan Province, Chengdu, China.
| | - Xiaolan Yu
- Department of Operation Room, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital of Sichuan University, Sichuan Province, Chengdu, China
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Mitobe Y, Yoshioka T, Baba Y, Yamaguchi Y, Nakagawa K, Itou T, Kurahashi K. Predictors of Catheter-Related Bladder Discomfort After Surgery: A Literature Review. J Clin Med Res 2023; 15:208-215. [PMID: 37187710 PMCID: PMC10181350 DOI: 10.14740/jocmr4873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023] Open
Abstract
Background Indwelling bladder catheters are routinely used in clinical practice. Patients may experience postoperative indwelling catheter-related bladder discomfort (CRBD). This study aimed to perform a literature review to identify predictors of postoperative CRBD. Methods We searched PubMed for relevant articles published between 2000 and 2020 using the search items "CRBD", "catheter-related bladder discomfort", and "prediction". Additionally, we searched for articles that matched the research objectives from the references of the extracted articles. We included only prospective observational studies involving human participants and excluded interventional studies, observational studies that did not report sample sizes, or observational studies that did not research on predictors of CRBD. We narrowed our search to the keyword "prediction" and found five references. We selected five studies that met the objectives of the study as the target literature. Results Using the keywords "CRBD" and "catheter-related bladder discomfort", we identified 69 published articles. The results were narrowed down by the keyword "prediction", and five studies that recruited 1,147 patients remained. The predictors of CRBD can be divided into four factors: 1) patient factors; 2) surgical factors; 3) anesthesia factors; and 4) device and insertion technique factors. Conclusion Our study suggests that patients with predictors of CRBD should be closely monitored to reduce postoperative patient suffering, and their quality of life should be improved after anesthesia.
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Affiliation(s)
- Yuta Mitobe
- Graduate School of Health and Welfare Science, International University of Health and Welfare, Tokyo, Japan
| | - Tomomi Yoshioka
- Department of Nursing, Faculty of Health Science, Tokoha University, Shizuoka, Japan
- Corresponding Author: Tomomi Yoshioka, Department of Nursing, Faculty of Health Science, Tokoha University, Shizuoka, Japan.
| | - Yasuko Baba
- Department of Anesthesiology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Yuri Yamaguchi
- Department of Anesthesiology, Yokohama City University Hospital, Kanagawa, Japan
| | - Kenji Nakagawa
- Department of Nursing, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Takeshi Itou
- Department of Nursing, Capital Metropolitan Bokutoh Hospital, Tokyo, Japan
| | - Kiyoyasu Kurahashi
- Department of Anesthesiology and Intensive Care Medicine, International University of Health and Welfare Narita Hospital, Chiba, Japan
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5
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Moeen AM. Editorial Comment on Transurethral lidocaine (100 mg) bladder irrigation (TULI100) reduces the incidence of catheter-related bladder discomfort in TURBT: A randomized, double-blind, controlled trial. Int J Urol 2023; 30:270-271. [PMID: 36541116 DOI: 10.1111/iju.15131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Ahmed M Moeen
- Urology and Nephrology Hospital, Assiut University, Assiut, Egypt
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6
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Bao X, Liu M, Li J, Yao H, Liu H, Tang G, Wang X, Zhou Z, Wu J, Cui Y. The efficacy of peripheral nerve block on postoperative catheter-related bladder discomfort in males: A systematic review and meta-analysis. Front Surg 2023; 10:1099628. [PMID: 36816007 PMCID: PMC9935611 DOI: 10.3389/fsurg.2023.1099628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
Objective To determine the efficacy of peripheral nerve block (PNB) in preventing postoperative catheter-related bladder discomfort (CRBD). Methods Up to July 1, 2022, the PubMed, Embase and Cochrane Central Register of Controlled Trials databases were searched, and all articles that met the PICOS (Patient, Intervention, Comparator, Outcome, Study design) criteria were enrolled. The included trials were evaluated using the Cochrane Collaboration's tool. Patients in the block group received bilateral PNB, while those in the non-block group did not need any additional procedure or simply achieved "sham block". CRBD was quantified using the visual analog scale (VAS) score, which was questioned and recorded at 0-1 h, 1-2 h, 4-8 h, 8-12 h and 12-24 h intervals. The incidences of CRBD, moderate to severe CRBD and postoperative nausea and vomiting (PONV) were meta-analysed. Results Six trials with a total of 544 patients were considered. First, the block group had a lower incidence of CRBD than the non-block group at 0-1 h (OR 0.22; 95% CI, 0.18-0.08; P < 0.0001), 1-2 h (OR 0.14; 95% CI, 0.08-0.26; P < 0.00001), 4-8 h (OR 0.27; 95% CI, 0.13 to 0.58; P < 0.0008) and 8-12 h (OR 0.51; 95% CI, 0.30 to 0.87; P = 0.01). Second, the block group showed a lower incidence of moderate to severe CRBD than the non-block group at 0-1 h, 1-2 h and 4-8 h, and the ORs were 0.12 (95% CI, 0.03 to 0.49; P = 0.003), 0.17 (95% CI, 0.08 to 0.37; P < 0.00001) and 0.29 (95% CI, 0.15 to 0.55; P = 0.0002),respectively. Finally, the block group was significantly associated with a decreased incidence of PONV (OR, 0.14; 95% CI, 0.05 to 0.39; P = 0.0002). Conclusion This meta-analysis suggested that PNB markedly reduced the incidence and severity of early postoperative CRBD and decreased the occurrence of PONV.
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Affiliation(s)
- Xingjun Bao
- Second Clinical Medical College, Binzhou Medical University, Yantai, China,Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Ming Liu
- Second Clinical Medical College, Binzhou Medical University, Yantai, China,Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Jie Li
- Department of Anesthesiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Huibao Yao
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Hongquan Liu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Gonglin Tang
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Xiaofeng Wang
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Zhongbao Zhou
- Department of Urology, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Jitao Wu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China,Correspondence: Yuanshan Cui Jitao Wu
| | - Yuanshan Cui
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China,Correspondence: Yuanshan Cui Jitao Wu
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7
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Liang S, Pang Z, Zhou N, Liu Z, Guo Q, Huang J, Zou W. Development and validation of a prediction model for catheter-related bladder discomfort: a prospective observational study. Br J Anaesth 2022; 129:e147-e149. [PMID: 36163078 DOI: 10.1016/j.bja.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/02/2022] [Accepted: 08/18/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Shuang Liang
- Department of Anaesthesiology, Central South University, Changsha, Hunan Province, China
| | - Zhaohua Pang
- Department of Anaesthesiology, Central South University, Changsha, Hunan Province, China
| | - Nannan Zhou
- Department of Anaesthesiology, Central South University, Changsha, Hunan Province, China
| | - Zhuoyi Liu
- Department of Anaesthesiology, Central South University, Changsha, Hunan Province, China
| | - Qulian Guo
- Department of Anaesthesiology, Central South University, Changsha, Hunan Province, China
| | - Jiapeng Huang
- Department of Anaesthesiology and Perioperative Medicine, University of Louisville, Louisville, KY, USA
| | - Wangyuan Zou
- Department of Anaesthesiology, Central South University, Changsha, Hunan Province, China; National Clinical Research Centre for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
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Bindal K, Kumar N, Oberoi D, Biswas M. Comparison between pre-emptive oral tramadol and tapentadol for attenuation of catheter-related bladder discomfort and surgical stress response in patients undergoing transurethral resection of prostate: A prospective, randomised, double-blind trial. Indian J Anaesth 2021; 65:S156-S162. [PMID: 34908567 PMCID: PMC8613468 DOI: 10.4103/ija.ija_445_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/18/2021] [Accepted: 09/27/2021] [Indexed: 11/23/2022] Open
Abstract
Background and Aims: Surgical interventions involving urinary catheterisation often lead to catheter-related bladder discomfort (CRBD). With a very high incidence rate of 47%–90%, CRBD often leads to a distressing and painful recovery after surgery. Although many opioids have been used for the treatment of CRBD, the search for the best is still going on. This study investigated the efficacy and tolerability of oral tapentadol and tramadol on postoperative CRBD. Methods: This was a prospective, randomised double-blind study. 100 patients, undergoing transurethral resection of the prostate were randomly assigned into two groups to receive tramadol 100 mg (Group A) or tapentadol 50 mg (Group B) orally 1 h before surgery. CRBD was evaluated on a 4-point severity scale in the post-operative area at 0, 0.5, 1, 2, 3, 4, 5 and 6 h. Pain and adverse effects were assessed postoperatively. Serum cortisol levels before and after the procedure were noted. Statistical analysis was done with the analysis of variance, t test. Results: Postoperative CRBD, 2 h after surgery was significantly reduced in group B than group A (P = 0.012). Cortisol levels, postoperatively were significantly lower in Group B (113 ± 65.45) (P = 0.001) than group A (162.64 ± 118.84 ng/dL). Dry mouth was seen in four, nausea in eight and sedation in six patients in group A while none in group B. 14 patients in Group A and one patient in Group B needed intravenous paracetamol (P = 0.000). Conclusions: Premedication with tapentadol was more effective in reducing CRBD and pain postoperatively. The surgical stress response and side effects were significantly reduced with tapentadol.
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Affiliation(s)
- Kriti Bindal
- Department of Anaesthesia, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Nidhi Kumar
- Department of Anaesthesia, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Deepak Oberoi
- Department of Anaesthesia, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Manoj Biswas
- Department of Urology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Göger YE, Özkent MS, Göger E, Kılınç MT, Ecer G, Pişkin MM, Erol A. A randomised-controlled, prospective study on the effect of dorsal penile nerve block after TURP on catheter-related bladder discomfort and pain. Int J Clin Pract 2021; 75:e13963. [PMID: 33368991 DOI: 10.1111/ijcp.13963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/21/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE In the present study, the impact of penile nerve block (PNB) on postoperative pain and Catheter-Related Bladder Discomfort (CRBD) in the transurethral resection of prostate(TURP) patients were evaluated. METHODS Participants of the present study were selected from patients who performed TURP under spinal anaesthesia for benign prostatic hyperplasia (BPH) between January 2018 and July 2020. The present study was planned as a single-centre, randomised-controlled prospective study in which the patients were divided into two groups. Group 1 was administered Control (n:40), and Group 2 ultrasonography(USG) guided PNB (n:40). The patients were included in the Groups, respectively. Visual analogue scale (VAS) scores were questioned and recorded in order to evaluate the postoperative pain complaints of the patients after the operation. In addition, in order to evaluate the CRBD, VAS scores were questioned and recorded as 0th, 0-1th hour, 1st-2nd hour, 2nd-4th hour, 4th-8th hour, 8th-12th hour, and 12th-24th hour. In addition, postoperative pain and need for analgesic drug were recorded. Tramadol was given to patients with moderate to severe CRBD. The findings were compared between the Groups. RESULTS There was no statistical difference demographic and per-operative data between Group 1 and Group 2. The CRBD and pain-related VAS scores were significantly higher in Group 1 between the 0 and 8th hours. There was no difference between VAS scores in the postoperative 8-24th hours. In total 24 hours, Group 2's need for tramadol was significantly less than Group 1. On examining the factors affecting CRBD in the multivariate analysis, age, body mass index(BMI), prostate volume, operation time do not affect CRBD statistically, and only PNB reduces CRBD (P: .029). While less drug-related complications were observed in Group 2, no serious complications related to PNB were observed. CONCLUSION Penile nerve block is an effective method for the decrease pain and CRBD after urological surgery. It will also reduce the need for analgesics, and provide painless patients in the postoperative period.
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Affiliation(s)
- Yunus Emre Göger
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | | | - Esra Göger
- Department of Anaesthesiology, Konya City Hospital, Konya, Turkey
| | - Muzaffer Tansel Kılınç
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Gökhan Ecer
- Department of Urology, Konya City Hospital, Konya, Turkey
| | - Mehmet Mesut Pişkin
- Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Atilla Erol
- Department of Anaesthesiology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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10
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Moataz A, Chadli A, Wichou E, Gallouo M, Jandou I, Saber S, Serhier Z, Dakir M, Debbagh A, Aboutaieb R. [Predictors of catheter-related bladder discomfort]. Prog Urol 2020; 30:1045-1050. [PMID: 33011083 DOI: 10.1016/j.purol.2020.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/14/2020] [Accepted: 09/04/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Establish a descriptive epidemiological profile of patients with Catheter Related Bladder Discomfort (CRBD) and identify its predictive factors. MATERIAL AND METHOD Between June 2019 and December 2019, 300 patients have been evaluated. Different parameters were taken into account including: sex, age, body mass index (BMI), historical health data, duration and indications of the urinary catheterization, type of the transurethral catheter used, lubrication of the catheter and the existence of CRBD. We grouped our patients according to the intensity of CRBD syndrome. The various factors likely to be correlated with the occurrence of CRBD were subject of a univariate then multivariate analysis. RESULTS 300 patients were included. The average age was 49 years (133 men and 167 women). 68 patients (22.6%) had history of urinary catheterization. 19% of patients were catheterized for acute urinary retention, while 81% were catheterized before surgery. The average duration of the urinary catheterization was 2.5 days. 54% showed CRBD symptoms, including more than 92% on the first day of the urinary catheterization. The significant risk factors in multivariate analysis were: the caliber of the catheter ≥18 Fr, the absence of lubrication, laparotomy, age <50 years, Cesarean and urinary catheterization medical history. CONCLUSION This study identified various factors incriminated in the occurrence of CRBD. The role of the hospital practitioner is to prevent this syndrome by reducing predictive factors, particularly the technical ones. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- A Moataz
- Service d'urologie, centre hospitalier universitaire Ibn Rochd, Casablanca, Maroc.
| | - A Chadli
- Service d'urologie, centre hospitalier universitaire Ibn Rochd, Casablanca, Maroc
| | - E Wichou
- Service d'urologie, centre hospitalier universitaire Ibn Rochd, Casablanca, Maroc
| | - M Gallouo
- Service d'urologie, centre hospitalier universitaire Ibn Rochd, Casablanca, Maroc
| | - I Jandou
- Service d'urologie, centre hospitalier universitaire Ibn Rochd, Casablanca, Maroc
| | - S Saber
- Centre des études doctorales, faculté de médecine et de pharmacie, université Hassan II, Casablanca, Maroc
| | - Z Serhier
- Service d'informatique médicale, faculté de médecine et de pharmacie, université Hassan II, Casablanca, Maroc
| | - M Dakir
- Service d'urologie, centre hospitalier universitaire Ibn Rochd, Casablanca, Maroc
| | - A Debbagh
- Service d'urologie, centre hospitalier universitaire Ibn Rochd, Casablanca, Maroc
| | - R Aboutaieb
- Service d'urologie, centre hospitalier universitaire Ibn Rochd, Casablanca, Maroc
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11
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Lee JH. RE: The effect of atropine in preventing catheter-related pain and discomfort in patients undergoing transurethral resection due to bladder tumor: a prospective, randomized, controlled study. Korean J Pain 2020; 33:286-287. [PMID: 32606274 PMCID: PMC7336350 DOI: 10.3344/kjp.2020.33.3.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 11/05/2022] Open
Affiliation(s)
- Joon-Ho Lee
- Department of Anesthesiology and Pain Medicine, Soonchunhyang University Bucheon Hospial, Bucheon, Korea
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12
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Li SY, Song LP, Ma YS, Lin XM. Predictors of catheter-related bladder discomfort after gynaecological surgery. BMC Anesthesiol 2020; 20:97. [PMID: 32345223 PMCID: PMC7187521 DOI: 10.1186/s12871-020-01018-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 04/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urinary catheterization is universally used during surgery, and the incidence of postoperative catheter-related bladder discomfort (CRBD) is very high during recovery. We conducted this study to identify the incidence and predictors of postoperative CRBD after gynaecological surgery in the post-anesthesia care unit (PACU). METHODS This was a prospective observational study. Patients undergoing gynaecological surgery under general anesthesia with intra-operative urinary catheterization were enrolled. We collected the clinical data, incidence and severity of CRBD, and postoperative pain for the patients. Predictive factors of CRBD were analysed by univariate and multivariate analysis. RESULTS A total of 407 patients were included in this study. The incidence of CRBD after gynaecological surgery was 64.6% (mild CRBD: 22.8%; moderate CRBD: 34.2%; and severe CRBD: 7.6%). Univariate analysis showed that age, type of surgery, type of laparoscopic surgery, additional analgesics, and postoperative pain were influencing factors for CRBD. Based on multivariate logistic regression analysis, age ≥ 50 years, uterus-related laparoscopic surgery, and lack of additional analgesics were independent predictors of moderate or severe CRBD. CONCLUSIONS This observational study revealed that the incidence of CRBD after gynaecological surgery in PACU was very high. Age ≥ 50 years, uterus-related laparoscopic surgery, and lack of additional analgesics were independent predictors of CRBD. TRIAL REGISTRATION ChiCTR1800016390. Registered on 30 May 2018.
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Affiliation(s)
- S Y Li
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, No.20, Section 3, Renmin Nanlu, Chengdu, China
| | - L P Song
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, No.20, Section 3, Renmin Nanlu, Chengdu, China
| | - Y S Ma
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, No.20, Section 3, Renmin Nanlu, Chengdu, China.
| | - X M Lin
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, No.20, Section 3, Renmin Nanlu, Chengdu, China
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Pournajafian A, Ghodraty MR, Shafighnia S, Rokhtabnak F, Khatibi A, Tavoosian S, Ghayoomi M. The Effect of Intravesical Diluted Bupivacaine on Catheter-Related Bladder Discomfort in Young and Middle-Aged Male Patients During Postanaesthetic Recovery. Turk J Anaesthesiol Reanim 2020; 48:454-459. [PMID: 33313583 PMCID: PMC7720825 DOI: 10.5152/tjar.2020.18999] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 09/26/2019] [Indexed: 02/05/2023] Open
Abstract
Objective Catheter-related bladder discomfort (CRBD) that manifests as agitation and bladder hyperactivity is a common problem in young male patients. Local anaesthetics are typically recommended for this problem. Hence, this study was conducted to determine the effect of intravesical diluted bupivacaine on CRBD in young male patients during postanaesthetic recovery. Methods This double-blinded randomised clinical trial included 68 consecutive patients, aged 20–60 years, who underwent urinary catheterisation during surgery and anaesthesia at a university hospital during 2017–2018. Patients were randomly assigned to receive either 50 ml of intravesical diluted (0.2%) bupivacaine (n=37) or normal saline (n=31). The incidence and severity of CRBD were then evaluated in PACU and compared between the two groups. Results In this study, 16.2% of patients in the bupivacaine group and 83.9% in the saline group had discomfort at arrival in the recovery room, exhibiting a significant intergroup difference (p=0.0001). Moreover, after 15–20 min, the incidence of CRBD was 16.2% and 90.3% in the bupivacaine and normal saline groups, respectively, which again demonstrated a significant statistical difference (p=0.0001). In addition, the severity of CRBD was lower in the bupivacaine group, during both periods (p=0.005). The saline group reported significantly higher use of pethidine and midazolam (p=0.005). Conclusion It may be concluded that intravesical diluted bupivacaine can significantly decrease the incidence and severity of CRBD in young male patients during recovery from anaesthesia. Therefore, the use of this method is highly recommended.
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Affiliation(s)
- Alireza Pournajafian
- Department of Anaesthesiology, Firoozgar Hospital. Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Ghodraty
- Department of Anaesthesiology, Firoozgar Hospital. Iran University of Medical Sciences, Tehran, Iran
| | - Shora Shafighnia
- Department of Anaesthesiology, Firoozgar Hospital. Iran University of Medical Sciences, Tehran, Iran
| | - Faranak Rokhtabnak
- Department of Anaesthesiology, Firoozgar Hospital. Iran University of Medical Sciences, Tehran, Iran
| | - Ali Khatibi
- Department of Anaesthesiology, Firoozgar Hospital. Iran University of Medical Sciences, Tehran, Iran
| | - Sina Tavoosian
- Department of Anaesthesiology, Firoozgar Hospital. Iran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Ghayoomi
- Department of Anaesthesiology, Firoozgar Hospital. Iran University of Medical Sciences, Tehran, Iran
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Park JY, Hong JH, Yu J, Kim DH, Koh GH, Lee SA, Hwang JH, Kong YG, Kim YK. Effect of Ketorolac on the Prevention of Postoperative Catheter-Related Bladder Discomfort in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy: A Randomized, Double-Blinded, Placebo-Controlled Study. J Clin Med 2019; 8:jcm8060759. [PMID: 31146434 PMCID: PMC6616938 DOI: 10.3390/jcm8060759] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 05/17/2019] [Accepted: 05/27/2019] [Indexed: 11/16/2022] Open
Abstract
Urinary catheterization can cause catheter-related bladder discomfort (CRBD). Ketorolac is widely used for pain control. Therefore, we evaluated the effect of ketorolac on the prevention of CRBD in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP). All patients were randomly allocated to the ketorolac group or the control group. The primary outcome was CRBD above a moderate grade at 0 h postoperatively. CRBD above a moderate grade at 1, 2, and 6 h was also assessed. Postoperative pain, opioid requirement, ketorolac-related complications, patient satisfaction, and hospitalization duration were also assessed. The incidence of CRBD above a moderate grade at 0 h postoperatively was significantly lower in the ketorolac group (21.5% vs. 50.8%, p = 0.001) as were those at 1, 2, and 6 h. Pain scores at 0 and 1 h and opioid requirement over 24 h were significantly lower in the ketorolac group, while patient satisfaction scores were significantly higher in the ketorolac group. Ketorolac-related complications and hospitalization duration were not significantly different between the two groups. This study shows ketorolac can reduce postoperative CRBD above a moderate grade and increase patient satisfaction in patients undergoing RALP, suggesting it is a useful option to prevent postoperative CRBD.
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Affiliation(s)
- Jun-Young Park
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
| | - Jun Hyuk Hong
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
| | - Jihion Yu
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
| | - Doo-Hwan Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
| | - Gi-Ho Koh
- Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju 61453, Korea.
| | - Sang-A Lee
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
| | - Jai-Hyun Hwang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
| | - Yu-Gyeong Kong
- Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07247, Korea.
| | - Young-Kug Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
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Li SY, Li H, Ni J, Ma YS. Comparison of intravenous lidocaine and dexmedetomidine infusion for prevention of postoperative catheter-related bladder discomfort: a randomized controlled trial. BMC Anesthesiol 2019; 19:37. [PMID: 30885134 PMCID: PMC6421662 DOI: 10.1186/s12871-019-0708-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/05/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Catheter-related bladder discomfort (CRBD) frequently occurs during recovery in patients who undergo intra-operative urinary catheterization. We conducted this study to compare the effect of intravenous lidocaine and dexmedetomidine infusion for preventing CRBD. METHODS 120 patients undergoing elective open abdominal hysterectomy or hysteromyomectomy requiring urinary bladder catheterization were randomly allocated into three groups of 40 each. Group L received a 2 mg/kg lidocaine bolus followed by infusion of 1.5 mg/kg/h; Group D received a 0.5 μg/kg dexmedetomidine bolus followed by infusion of 0.4 μg/kg/h; Group C received a bolus and infusion of normal saline of equivalent volume. The incidence and different severity (mild, moderate, and severe) of CRBD were assessed on arrival in the postanaesthesia care unit at 0, 1, 2, and 6 h postoperatively. RESULTS The incidence of CRBD was significantly lower in Group L and Group D compared with Group C at 0, 1, and 2 h. However, there was no significant difference among the three groups regarding the different severity of CRBD at all time points. The requirement of rescue tramadol for CRBD was lower in group L and group D than in group C. The incidence of sedation was significantly higher in Group D compared to Group L and Group C, though no difference in other adverse effects was observed. CONCLUSIONS Intravenous lidocaine and dexmedetomidine infusion reduced the incidence of CRBD as well as the additional tramadol requirement for CRBD, but had no effect on the different severity of CRBD. TRIAL REGISTRATION ChiCTR-INR-16009162 . Registered on 5 September 2016.
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Affiliation(s)
- S Y Li
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, No.20, Section 3, Renmin Nanlu, Chengdu, China
| | - H Li
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, No.20, Section 3, Renmin Nanlu, Chengdu, China
| | - J Ni
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, No.20, Section 3, Renmin Nanlu, Chengdu, China.
| | - Y S Ma
- Department of Anesthesiology, West China Second Hospital of Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children, No.20, Section 3, Renmin Nanlu, Chengdu, China
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16
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Li S, Song L, Ma Y, Lin X. Tramadol for the treatment of catheter-related bladder discomfort: a randomized controlled trial. BMC Anesthesiol 2018; 18:194. [PMID: 30572837 PMCID: PMC6302399 DOI: 10.1186/s12871-018-0659-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/03/2018] [Indexed: 11/15/2022] Open
Abstract
Background Intra-operative urinary catheterization frequently causes postoperative catheter related bladder discomfort (CRBD) during recovery. We conducted this study to evaluate the efficacy of tramadol, which with muscarinic receptor antagonist property, as a treatment for CRBD. Methods Ninety patients who underwent elective gynecological surgery and complained of CRBD in the (PACU) were randomized into three groups of 30 each. Group A received normal saline, group B 1 mg/kg tramadol, and group C 1.5 mg/kg tramadol. The medication was administered from the Murphy’s dropper with a slow drip, and the severity of CRBD (none, mild, moderate, and severe) and postoperative pain were assessed after 0, 0.5, 1, 2 and 6 h. Results The severity of CRBD was reduced in group C compared with that in groups A and B at 1 h, and in groups C and B compared with that in group A at 2 h. The incidence of CRBD was reduced in group C compared with that in groups A and B at 2 h, and in group C compared with that in group A at 6 h. The visual analog scale (VAS) was reduced in group C compared with that in groups A and B at all time intervals. No differences in adverse effects were observed. Conclusions Tramadol 1.5 mg/kg was more effective than tramadol 1 mg/kg in treating CRBD and reducing postoperative pain, without significant side effects. Trial registration ChiCTR1800016390. Registered on 30 May 2018.
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Affiliation(s)
- Shuying Li
- Department of Anesthesiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second Hospital of Sichuan University, Chengdu, China
| | - Liping Song
- Department of Anesthesiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second Hospital of Sichuan University, Chengdu, China
| | - Yushan Ma
- Department of Anesthesiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second Hospital of Sichuan University, Chengdu, China.
| | - Xuemei Lin
- Department of Anesthesiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children, West China Second Hospital of Sichuan University, Chengdu, China
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Management of urinary-tract fistulas using reversible balloon nephrostomy: a single-center retrospective analysis of 56 patients. Int Urogynecol J 2018; 30:287-292. [PMID: 29546601 DOI: 10.1007/s00192-018-3628-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 03/01/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate the effectiveness of balloon nephrostomy (BN) for treating urinary tract fistulas. MATERIALS AND METHODS In a single-center retrospective analysis, 56 patients were treated using BN between 2003 and 2014. All causes of urinary tract fistula were included. We assessed the effectiveness of drainage, complications, and the types of reconstruction surgery used. Success was defined as fistula closure without surgery. RESULTS The cohort consisted of 25 males (54%) and 31 females (55%) with a median age of 63 years who underwent BN for a urinary fistula secondary to surgery, i.e., urologic (40%; n = 22), gynecologic (34%; n = 19), or digestive (20%; n = 11). Of these patients, 48 (86%) had a history of cancer (49% had a tumor progression). Median drainage time was 90 days (10-583), with an average of three successive readjustments needed per patient. We obtained a 21% success rate (n = 12), morbidity was 6.5% (urinary sepsis, renal abscess, ureteral stricture), and 7% of patients developed ureteral stricture after balloon removal. There was no recurrence of any fistula within a median follow-up time of 15.2 months. CONCLUSION This minimally invasive procedure can be used for selected urinary tract fistulas with few complications. It can also be used safely in populations that have several comorbidities.
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18
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Maghsoudi R, Farhadi-Niaki S, Etemadian M, Kashi AH, Shadpour P, Shirani A, Samadinezhad-Khoshbaf-Sorkhabi R, Tabatabaei M. Comparing the Efficacy of Tolterodine and Gabapentin Versus Placebo in Catheter Related Bladder Discomfort After Percutaneous Nephrolithotomy: A Randomized Clinical Trial. J Endourol 2018; 32:168-174. [DOI: 10.1089/end.2017.0563] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Robab Maghsoudi
- Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Farhadi-Niaki
- Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Etemadian
- Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amir H Kashi
- Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran
| | - Pejman Shadpour
- Hasheminejad Kidney Center, Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Asemaneh Shirani
- Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran
| | | | - Meghdad Tabatabaei
- Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran
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Sabetian G, Zand F, Asadpour E, Ghorbani M, Adibi P, Hosseini MM, Zeyghami S, Masihi F. Evaluation of hyoscine N-butyl bromide efficacy on the prevention of catheter-related bladder discomfort after transurethral resection of prostate: a randomized, double-blind control trial. Int Urol Nephrol 2017; 49:1907-1913. [PMID: 28808847 DOI: 10.1007/s11255-017-1663-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 07/17/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Transurethral resection of prostate (TURP) is the most common treatment for benign prostatic hyperplasia (BPH). Urinary tract catheter is inserted post-operatively which results in catheter-related bladder discomfort (CRBD) in many patients. The purpose of this study was to assess the preventive effect of hyoscine N-butyl bromide on CRBD caused by a urinary tract catheter after TURP surgery in patients with BPH. METHODS Twenty-four and twenty-six patients in the treatment and control groups were enrolled, respectively. At the end of the surgery, slow intravenous injection of 20 mg hyoscine N-butyl bromide was administered to the patients of treatment group. The severity of CRBD was followed up at five different time periods and up to 2 h after surgery. RESULTS On arrival to PACU and after 30 min of injection, statistically significant less CRBD was seen in the treatment group comparing to the control group (P ≤ 0.05 and P ≤ 0.007). The total utilized meperidine dose during PACU stay and the time to discharge for the intervention group were significantly lower than those for the control group (P ≤ 0.0001) with no significant difference in adverse effects (P > 0.05). CONCLUSIONS Hyoscine N-butyl bromide could reduce the severity of CRBD related to TURP in patients with BPH and their need for analgesic consumption either. It shortened the length of stay in the recovery room. Regarding its availability and low cost, it can be an effective pain relief drug for CRBD discomfort related to TURP in BPH patients.
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Affiliation(s)
- Golnar Sabetian
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farid Zand
- Anaesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elham Asadpour
- Anaesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Ghorbani
- Torbat Heydarieh University of Medical Sciences, Torbat Heydarieh, Iran
| | - Pourya Adibi
- Anaesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Shahryar Zeyghami
- Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Masihi
- Anaesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Mu L, Geng LC, Xu H, Luo M, Geng JM, Li L. Lidocaine-prilocaine cream reduces catheter-related bladder discomfort in male patients during the general anesthesia recovery period: A prospective, randomized, case-control STROBE study. Medicine (Baltimore) 2017; 96:e6494. [PMID: 28383414 PMCID: PMC5411198 DOI: 10.1097/md.0000000000006494] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Urethral catheterization is a predictor of agitation during the general anesthesia recovery period. The aim of this study was to determine the effect of intraurethral 5% lidocaine and 25 mg/g prilocaine cream in reducing catheter-related bladder discomfort (CRBD) in male patients during the general anesthesia recovery period. Adult male patients undergoing elective operations that required urinary catheterization under general anesthesia were enrolled and assigned randomly to 2 groups. In the lidocaine-prilocaine cream group (n = 72), approximately 5 g of topical cream was spread in the preputial sac, the glans, the meatus, and on the urinary catheter surface before urinary catheterization. In the control group (n = 74), the urinary catheter was lubricated with lidocaine gel. The incidence and severity of CRBD were assessed 15, 30, 45, and 60 minutes postoperatively. We found that the incidence of CRBD in the lidocaine-prilocaine cream group was significantly lower than in the control group. Multivariate logistic regression analysis showed that lidocaine-prilocaine cream applications reduced moderate or severe CRBD. Thirty minutes postoperation was the most frequent time point for the incidence of CRBD. Application of lidocaine-prilocaine cream on the surface of the urinary catheter is an efficient and safe method to reduce the incidence and severity of CRBD.
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Affiliation(s)
| | - Li-cheng Geng
- Department of Anesthesia, Tianjin Union Medical Center, Tianjin, China
| | | | - Man Luo
- Department of Anesthesia, Tianjin Union Medical Center, Tianjin, China
| | | | - Li Li
- Department of Anesthesia, Tianjin Union Medical Center, Tianjin, China
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Akça B, Aydoğan-Eren E, Canbay Ö, Karagöz AH, Üzümcügil F, Ankay-Yilbaş A, Çelebi N. Comparison of efficacy of prophylactic ketamine and dexmedetomidine on postoperative bladder catheter-related discomfort. Saudi Med J 2017; 37:55-9. [PMID: 26739975 PMCID: PMC4724680 DOI: 10.15537/smj.2016.1.14122] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objectives: To compare the effects of prophylactic ketamine and dexmedetomidine on postoperative bladder catheter-related discomfort/pain in patients undergoing cystoscopy. Methods: This prospective study was conducted on 75 American Society of Anesthesiologists (ASA) I-II patients between 18-75 years of age and undergoing cystoscopy between November 2011 and June 2012 at Hacettepe University Hospital, Ankara, Turkey. Patients were randomly assigned to one of the 3 groups to receive 1 µ/kg dexmedetomidine, 250 µ/kg intravenous ketamine, or normal saline. All patients were questioned regarding probe-related discomfort, patient satisfaction, and pain at the end of the operation 0 (t0) and 15 (t1), 60 (t2), 120 (t3), and 360 (t4) minutes postoperatively. Evaluations were performed in person at the post-anesthesia care unit, or in ambulatory surgery rooms, or by phone calls. Results: Pain incidence in the dexmedetomidine and ketamine groups (p=0.042) was significantly lower than that in the control group (p=0.044). The sedation scores recorded at t0 in the dexmedetomidine and ketamine groups (p=0.004) were significantly higher than that of the control group (p=0.017). Patient groups were similar regarding the rate of hallucinations experienced at t1, no patients experienced hallucinations at t2, t3, or t4. Significantly more patients experienced hallucinations at t0 in the ketamine group than in the dexmedetomidine group (p=0.034) and the control group (p=0.005). Conclusion: Dexmedetomidine and ketamine had similar analgesic effects in preventing catheter-related pain; however, dexmedetomidine had a more acceptable side effect profile. To identify the optimal doses of dexmedetomidine and ketamine, more large-scale interventional studies are needed.
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Affiliation(s)
- Başak Akça
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Hacettepe University, Ankara, Turkey. E-mail.
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Factors Predicting Catheter-Related Bladder Discomfort in Surgical Patients. J Perianesth Nurs 2016; 32:400-408. [PMID: 28938975 DOI: 10.1016/j.jopan.2016.03.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 02/22/2016] [Accepted: 03/04/2016] [Indexed: 11/23/2022]
Abstract
PURPOSE The study was conducted to identify the factors predicting catheter-related bladder discomfort (CRBD) in the postanesthesia care unit, to assess the level of CRBD and urinary catheter-related pain for the first 24 hours postoperatively, and to compare UCRP with the postoperative pain in the surgical site. BACKGROUND About 20% of hospitalized patients receive an indwelling urinary catheter, and more than half of these patients complain of CRBD or urinary catheter-related pain. DESIGN This prospective descriptive study conducted in an 800-bed university hospital involved 160 patients who had undergone elective surgery from February 5, 2012 to June 5, 2012. METHODS Demographic data including gender, age, American Society of Anesthesiologists class, weight, and height were collected on the preoperative visit. Factors predicting CRBD were identified by multiple logistic regression analysis. Comparison of the UCRP and postoperative pain was analyzed using the Mann-Whitney U test. FINDINGS Multiple logistic regression analysis showed that the factors predicting CRBD ≥2 30 minutes after arrival to the postanesthesia care unit were age <50 years (odds ratio [OR], 4.79; P = .005), male gender (OR, 7.07; P = .015), obstetric and gynecological surgery (OR, 11.07; P = .045), and UCRP (OR, 132.3; P < .015). Postoperative pain (P < .001) was significantly greater than UCRP. CONCLUSIONS Age <50 years, male gender, open abdominal surgery, and UCRP ≥4 predict CRBD. CLINICAL RELEVANCE Perioperative care providers should screen surgical patients for risk factors of CRBD during the first postoperative 12 hours.
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Bai Y, Wang X, Li X, Pu C, Yuan H, Tang Y, Li J, Wei Q, Han P. Management of Catheter-Related Bladder Discomfort in Patients Who Underwent Elective Surgery. J Endourol 2014; 29:640-9. [PMID: 25335575 DOI: 10.1089/end.2014.0670] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Despite the various treatment and prevention options for catheter-related bladder discomfort (CRBD), many uncertainties persist in clinical practice. To systematically review the literature on the management of CRBD in patients who underwent surgery. MATERIALS AND METHODS Eligible, randomized controlled trials were identified from electronic databases (Cochrane Central Register of Controlled Trials, Medline, and EMBASE) without language restrictions. Selection criteria, methodological rigor, and risk of bias were evaluated by two independent reviewers using Cochrane Collaboration's tools. RESULTS A total of 1441 patients from 14 articles published between 2005 and 2014 were included. Data heterogeneity precluded meta-analysis; therefore, data were synthesized narratively. Compared with nonurological surgery, CRBD is frequent and occurred immediately after urological surgery, especially after transurethral resection of the bladder tumor (TURBT). Data from included studies suggested that muscarinic antagonists, anesthetics, antiepileptics, and analgesics were associated with significant improvement in symptoms and reducing the incidence of CRBD, compared with placebo. Anticholinergic agents and antiepileptics (gabapentin and pregabalin) administered 1 hour before surgery reduced the incidence and severity of CRBD in the immediate postoperative period. Tramadol and ketamine are centrally acting opioid analgesics with antimuscarinic actions, which effectively prevent CRBD when administered intravenously. Paracetamol administered was also effective for the management of CRBD. Additionally, we perceived that TURBT is the surgical procedure that is the most refractory to treatment. CONCLUSIONS Muscarinic antagonists, anesthetics, antiepileptics, and paracetamol appear to achieve the greatest improvement in the clinical symptoms and a significant reduction in the incidence of CRBD compared with placebo. Although these studies observed a high incidence of intervention-related side effects, in general, patients tolerated these treatments well.
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Affiliation(s)
- Yunjin Bai
- 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China
| | - Xianding Wang
- 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China
| | - Xiaoqiang Li
- 2 Department of Anesthesiology, West China Hospital, Sichuan University , Chengdu, China
| | - Chunxiao Pu
- 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China
| | - Haichao Yuan
- 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China
| | - Yin Tang
- 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China
| | - Jinhong Li
- 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China
| | - Qiang Wei
- 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China
| | - Ping Han
- 1 Department of Urology, West China Hospital, Sichuan University , Chengdu, China
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