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Cohen SM, Baimas-George M, Ponce C, Chen N, Bain PA, Ganske IM, Katz J, Luks FI, Kent TS. Is a Picture Worth a Thousand Words? A Scoping Review of the Impact of Visual Aids on Patients Undergoing Surgery. JOURNAL OF SURGICAL EDUCATION 2024; 81:1276-1292. [PMID: 38955659 DOI: 10.1016/j.jsurg.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/24/2024] [Accepted: 06/02/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE While graphics are commonly used by clinicians to communicate information to patients, the impact of using visual media on surgical patients is not understood. This review seeks to understand the current landscape of research analyzing impact of using visual aids to communicate with patients undergoing surgery, as well as gaps in the present literature. DESIGN A comprehensive literature search was performed across 4 databases. Search terms included: visual aids, diagrams, graphics, surgery, patient education, informed consent, and decision making. Inclusion criteria were (i) full-text, peer-reviewed articles in English; (ii) evaluation of a nonelectronic visual aid(s); and (iii) surgical patient population. RESULTS There were 1402 articles identified; 21 met study criteria. Fifteen were randomized control trials and 6 were prospective cohort studies. Visual media assessed comprised of diagrams as informed consent adjuncts (n = 6), graphics for shared decision-making conversations (n = 3), other preoperative educational graphics (n = 8), and postoperative educational materials (n = 4). There was statistically significant improvement in patient comprehension, with an increase in objective knowledge recall (7.8%-29.6%) using illustrated educational materials (n = 10 of 15). Other studies noted increased satisfaction (n = 4 of 6), improvement in shared decision-making (n = 2 of 4), and reduction in patient anxiety (n = 3 of 6). For behavioral outcomes, visual aids improved postoperative medication compliance (n = 2) and lowered postoperative analgesia requirements (n = 2). CONCLUSIONS The use of visual aids to enhance the surgical patient experience is promising in improving knowledge retention, satisfaction, and reducing anxiety. Future studies ought to consider visual aid format, and readability, as well as patient language, race, and healthcare literacy.
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Affiliation(s)
- Stephanie M Cohen
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Center for Visual Arts in Healthcare, Brigham and Women's Hospital, Boston, Massachusetts.
| | - Maria Baimas-George
- Department of Transplant Surgery, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Cristina Ponce
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Nova Chen
- Department of Neuroscience, Brown University, Providence, Rhode Island
| | - Paul A Bain
- Department of Research and Instruction, Harvard Medical School, Boston, Massachusetts
| | - Ingrid M Ganske
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Massachusetts; Center for Visual Arts in Healthcare, Brigham and Women's Hospital, Boston, Massachusetts
| | - Joel Katz
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Center for Visual Arts in Healthcare, Brigham and Women's Hospital, Boston, Massachusetts
| | - Francois I Luks
- Department of Surgery, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Tara S Kent
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Bang YJ, Kim S, Kim JK, Kim H, Kim S, Chung CS, Yoo SY, Jeong H, Park B, Lee SH. Effect of preoperative patient education and simulated mouth breathing training on opioid requirements in the post-anesthesia care unit after nasal surgery: a randomized controlled study. BMC Anesthesiol 2023; 23:348. [PMID: 37864142 PMCID: PMC10588134 DOI: 10.1186/s12871-023-02310-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 10/14/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND A simulated education, prior to surgery about postoperative nasal stuffiness and ease of breathing through the mouth may help patients tolerate discomfort after nasal surgery. This study aimed to investigate the effect of preoperative simulated education on immediate postoperative opioid requirements in patients undergoing elective nasal surgery. METHODS This randomized controlled trial of 110 patients undergoing nasal surgery randomly allocated patients into either a control (group C) or an education group (group E). One day before surgery, patients in group E were intensively trained to breathe through the mouth by using a nasal clip, with informative explanations about inevitable nasal obstruction and discomfort following surgery. Patients in group C were provided with routine preoperative information. Total intravenous anesthesia (TIVA) with propofol and remifentanil was used for anesthesia. No further opioid was used for analgesia intraoperatively. The primary outcome was index opioid (fentanyl) requirements at the post-anesthesia recovery unit (PACU). Secondary outcomes were emergence agitation, pain scores at the PACU, and postoperative recovery using the Quality of Recovery-15 (QoR15-K). RESULTS The rate of opioid use in the PACU was 51.0% in the group E and 39.6% in the group C (p = 0.242). Additional request for analgesics other than index opioid was not different between the groups. Emergence agitation, postoperative pain severity, and QoR15-K scores were comparable between the groups. CONCLUSION Preoperative education with simulated mouth breathing in patients undergoing nasal surgery did not reduce opioid requirements. TRIAL REGISTRATION KCT0006264; 16/09/2021; Clinical Research Information Services ( https://cris.nih.go.kr ).
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Affiliation(s)
- Yu Jeong Bang
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Sojin Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Jin Kyoung Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Hara Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Seungmo Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Chi Song Chung
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Seung Yeon Yoo
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Heejoon Jeong
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Boram Park
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Sang Hyun Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
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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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Park JY, Baek JW, Yu J, Kim CS, Bae J, Kim YK. Vitamin C and catheter-related bladder discomfort after transurethral resection of bladder tumor: A double-blind, randomized, placebo-controlled study. J Clin Anesth 2023; 89:111191. [PMID: 37356194 DOI: 10.1016/j.jclinane.2023.111191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 06/27/2023]
Abstract
STUDY OBJECTIVE We evaluated the effect of vitamin C administration on postoperative catheter-related bladder discomfort (CRBD). DESIGN A double-blind, randomized controlled trial. SETTING University tertiary hospital. PATIENTS The participants were patients undergoing transurethral resection of bladder tumor. INTERVENTION Patients were randomly assigned to either vitamin C (n = 59) or control (n = 59). The vitamin C group received 1 g of vitamin C intravenously and the control group received normal saline, administered after the induction of anesthesia. MEASUREMENTS The primary endpoint was moderate or greater CRBD immediately postoperatively. Secondary outcomes included the incidence of moderate or greater CRBD at 1, 2, and 6 h postoperatively. The symptom of CRBD is either a burning sensation with an urge to void or discomfort in the suprapubic area. Moderate CRBD was defined as spontaneously reported by the patient without any behavioral responses, such as attempts to remove the urinary catheter, intense verbal reactions, and flailing limbs. Severe CRBD was spontaneously reported by the patient with behavioral responses. Patient satisfaction scores were also evaluated. MAIN RESULTS The group that received vitamin C exhibited a significantly lower incidence of moderate or greater CRBD immediately postoperatively compared with the control group (17 [28.8%] vs. 40 [67.8%], p < 0.001, relative risk [95% confidence interval] = 0.426 [0.274-0.656]). The vitamin C group also showed a significantly lower incidence of moderate or greater CRBD at 1 and 2 h postoperatively compared with the control group (10 [16.9%] vs. 25 [42.4%], p = 0.003; and 5 [8.5%] vs. 16 [27.1%], p = 0.008, respectively). However, there was no significant difference in the incidence of moderate or greater CRBD 6 h postoperatively. Patient satisfaction scores were significantly higher in the vitamin C group than in the control group (5.0 ± 1.3 vs. 4.4 ± 1.4, p = 0.009). CONCLUSIONS Patients who received vitamin C had decreased CRBD and improved patient satisfaction following transurethral resection of bladder tumor.
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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, Republic of Korea
| | - Ji-Won Baek
- Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Jihion Yu
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Chan-Sik Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jangho Bae
- Department of Anesthesiology and Pain Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Young-Kug Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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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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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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Li S, Li P, Wang R, Li H. Different interventions for preventing postoperative catheter-related bladder discomfort: a systematic review and meta-analysis. Eur J Clin Pharmacol 2022; 78:897-906. [PMID: 35218404 DOI: 10.1007/s00228-021-03251-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 11/08/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Catheter-related bladder discomfort (CRBD) is a common complication of intraoperative urinary catheterization. Various studies have evaluated the efficacy of different interventions in postoperative CRBD. The present review was performed to assess the efficacy of these interventions. METHODS PubMed, Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases were systematically searched to identify randomized controlled trials (RCTs) investigating the efficacy of different drugs for the prevention of postoperative CRBD. This review evaluated the incidence and severity of CRBD after different interventions at 0, 1, 2, and 6 h postoperatively. RESULTS Forty-five studies including 31 different drugs were analyzed. Eleven drugs were investigated in more than two RCTs, of which dexmedetomidine, gabapentin, tolterodine, tramadol, ketamine, nefopam, oxybutynin, pregabalin, and pudendal nerve block (PNB) generally showed significantly higher efficacy than controls postoperatively. Solifenacin only showed significant efficacy compared with the control at 0 h, and intravenous lidocaine only showed significant efficacy compared with the control at 6 h. There were insufficient trials to draw conclusions regarding atropine, butylscopolamine, chlorpheniramine, clonidine, darifenacin, diphenhydramine, glycopyrrolate, intravesical bupivacaine, ketamine-haloperidol, pethidine-haloperidol, ketorolac, lidocaine-prilocaine cream, magnesium, hyoscine n-butyl bromide, oxycodone, paracetamol, parecoxib, trospium, resiniferatoxin, or amikacin. However, all but pethidine-haloperidol and chlorpheniramine showed some efficacy at various time points compared with controls. CONCLUSION This review suggests that dexmedetomidine, gabapentin, tolterodine, tramadol, ketamine, nefopam, oxybutynin, pregabalin, and PNB are effective in preventing postoperative CRBD. Considering the efficacy and adverse effects of all drugs, dexmedetomidine and gabapentin were ranked best.
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Affiliation(s)
- Shuying Li
- Department of Anesthesiology, West China Second Hospital, Sichuan University, Key Laboratory of Birth Deficits and Related Diseases of Women and Children, Sichuan University, Ministry of education, Renmin Nanlu, Chengdu, China
| | - Ping Li
- Department of Anesthesiology, West China Second Hospital, Sichuan University, Key Laboratory of Birth Deficits and Related Diseases of Women and Children, Sichuan University, Ministry of education, Renmin Nanlu, Chengdu, China
| | - Rurong Wang
- Department of Anesthesiology,West China Hospital, Sichuan University, Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, Guoxue Alley, No 37, Chengdu, China.
| | - Hui Li
- Department of Anesthesiology, West China Second Hospital, Sichuan University, Key Laboratory of Birth Deficits and Related Diseases of Women and Children, Sichuan University, Ministry of education, Renmin Nanlu, Chengdu, China
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Estel K, Weber G, Richter L, Hofmann M, Ruckdeschel P, Märdian S, Willy C, Back DA. Acceptance of Supportive Illustrations for Preparation of Patients for an Orthopedic Telemedical Consultation. Front Surg 2021; 8:696721. [PMID: 34631777 PMCID: PMC8492955 DOI: 10.3389/fsurg.2021.696721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Telemedical video consultations are a powerful support for patient–doctor interactions. For optimal digital settings, explanatory illustrations may be helpful for patients. This study analyzed patients' the attitude of patients to illustrations preparing for an orthopedic telemedical consultation (OTC). Methods: A leaflet with eight illustrations was designed and their acceptance and estimated necessity was evaluated among patients who had experienced an OTC (EXP-group) and others who had not (NOV-group) with a 12-item-questionnaire. Results: Sixty patients participated (n = 30 each group). All illustrations were evaluated positively. The EXP-group gave significantly higher ratings than the NOV-group for improved understanding by the given keywords of the illustrations (p = 0.046), preference for being informed by illustrations than by merely by a pure text (p = 0.023), better feeling of preparation for an OTC by the illustrations (p = 0.005), and the impression of a simplified process of the OTC by the illustrations (p = 0.012). Discussion: While the illustrations were well-accepted by the participants, significant differences were revealed between the valuation of single aspects by patients, depending on a previous experience with an OTC. Therefore, a leaflet with explanatory illustrations may be helpful in preparing patients for an OTC to support the digital patient–doctor contact.
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Affiliation(s)
- Katharina Estel
- Clinic for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Gordian Weber
- Clinic for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany
| | - Luise Richter
- Clinic for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany.,Medical Faculty of the Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Marko Hofmann
- Institute for Computer Engineering Faculty of Computer Science, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Patrick Ruckdeschel
- Institute for Computer Engineering Faculty of Computer Science, University of the Bundeswehr Munich, Neubiberg, Germany
| | - Sven Märdian
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Willy
- Clinic for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany
| | - David Alexander Back
- Clinic for Traumatology and Orthopedics, Bundeswehr Hospital Berlin, Berlin, Germany.,Dieter Scheffner Center for Medical Education and Educational Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Abstract
Background
Catheter-related bladder discomfort occurs because of involuntary contractions of the bladder smooth muscle after urinary catheterization. Magnesium is associated with smooth muscle relaxation. This study hypothesized that among patients having transurethral resection of bladder tumor, magnesium will reduce the incidence of postoperative moderate-to-severe catheter-related bladder discomfort.
Methods
In this double-blind, randomized study, patients were randomly allocated to the magnesium group (n = 60) or the control group (n = 60). In magnesium group, a 50 mg/kg loading dose of intravenous magnesium sulfate was administered for 15 min, followed by an intravenous infusion of 15 mg · kg−1 · h−1 during the intraoperative period. Patients in the control group similarly received normal saline. The primary outcome was the incidence of catheter-related bladder discomfort above a moderate grade at 0 h postoperatively. None, mild, moderate, and severe catheter-related bladder discomfort at 1, 2, and 6 h postoperatively, patient satisfaction, and magnesium-related adverse effects were also assessed.
Results
The incidence of catheter-related bladder discomfort above a moderate grade at 0 h postoperatively was significantly lower in the magnesium group than in the control group (13 [22%] vs. 46 [77%]; P < 0.001; relative risk = 0.283; 95% CI, 0.171 to 0.467; absolute risk reduction = 0.55; number needed to treat = 2); similar results were observed for catheter-related bladder discomfort above a moderate grade at 1 and 2 h postoperatively (5 [8%] vs. 17 [28%]; P = 0.005; relative risk = 0.294; 95% CI, 0.116 to 0.746; and 1 [2%] vs. 14 [23%]; P < 0.001; relative risk = 0.071; 95% CI, 0.010 to 0.526, respectively). Patient satisfaction on a scale from 1 to 7 was significantly higher in the magnesium group than in the control group (5.1 ± 0.8 vs. 3.5 ± 1.0; P < 0.001; 95% CI, 1.281 to 1.919). Magnesium-related adverse effects were not significantly different between groups.
Conclusions
Magnesium reduced the incidence of catheter-related bladder discomfort above a moderate grade and increased patient satisfaction among patients having transurethral resection of bladder tumor.
Editor’s Perspective
What We Already Know about This Topic
What This Article Tells Us That Is New
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Şahiner Y, Yağan Ö, Akdağlı Ekici A, Ekici M, Demir E. The effect of atropine in preventing catheter-related pain and discomfort in patients undergoing transurethral resection due to bladder tumor; prospective randomized, controlled study. Korean J Pain 2020; 33:176-182. [PMID: 32235018 PMCID: PMC7136298 DOI: 10.3344/kjp.2020.33.2.176] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/11/2019] [Accepted: 12/16/2019] [Indexed: 12/19/2022] Open
Abstract
Background Catheter-related bladder discomfort (CRBD) has been observed in many patients undergoing a urethral catheterization. CRBD may be so severe that the patients require additional analgesics. Muscarinic receptors are involved in the mechanism of CRBD. The aim of this study is to determine the effects of the antimuscarinic properties of atropine, which is frequently used in current practice on CRBD, by comparing it with sugammadex which has no antimuscarinic effects. Methods Sixty patients selected for transurethral resection due to bladder tumors were randomized into 2 groups: an atropine group and a sugammadex group, with no antimuscarinic effect. The patients were given rocuronium (0.6 mg/kg) as a neuromuscular-blocker. In addition to the frequency and severity of CRBD postoperatively at 0, 1, 6, 12, and 24 hours, postoperative numeric rating scale (NRS) scores, and postoperative nausea and vomiting were examined. Results The incidence of CRBD was significantly lower in the atropine group in all postoperative measurements. The score was found to be significantly lower in the atropine group when NRS measurements were performed at all time periods (P < 0.01). There was no difference between the groups in terms of nausea and vomiting (P > 0.05). Conclusions Atropine is a cheap, easy-to-access, safe-to-use drug for reducing CRBD symptoms, without any observed adverse effects. Since it not only reduces CRBD symptoms but also has a positive effect on postoperative pain, it can be used safely to increase patient comfort in patients receiving general anesthesia and a urinary catheter.
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Affiliation(s)
- Yeliz Şahiner
- Department of Anesthesiology and Reanimation, Erol Olçok Training and Research Hospital, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Özgür Yağan
- Department of Anesthesiology and Reanimation, Erol Olçok Training and Research Hospital, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Arzu Akdağlı Ekici
- Department of Anesthesiology and Reanimation, Erol Olçok Training and Research Hospital, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Musa Ekici
- Department of Urology, Erol Olçok Training and Research Hospital, Hitit University Faculty of Medicine, Çorum, Turkey
| | - Emre Demir
- Department of Biostatistics, Hitit University Faculty of Medicine, Çorum, Turkey
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