Effect of Intraoperative Paracetamol on Catheter-Related Bladder Discomfort: A Prospective, Randomized, Double-Blind Study

Abstract

Intraoperative single-dose paracetamol was found to be effective in reducing the severity of CRBD and pain in urologic surgery. We suggest that it may be an efficient, reliable, easy-to-apply drug for CRBD. ClinicalTrials.gov identifier: NCT01652183.

Management of Catheter-Related Bladder Discomfort in Patients Who Underwent Elective Surgery

“…The absolute risk reductions in the experimental group compared with the control group at 6 hours after surgery were 28% to 59% for TURBT (pooled RR: 0.55, 95% CI: 0.31, 0.99, p = 0.04), 4,5 39% to 59% for PNCL (pooled RR: 0.51, 95% CI: 0.37, 0.70, p < 0.001), 3,12,13 and 66% to 67% for nonurological surgery (pooled RR: 0.26, 95% CI: 0.11, 0.59, p = 0.001). Obviously, the effectiveness of the intervention at 6 hours after TURBT was lesser than nonurological surgery.…”

“…Paracetamol: Ergenoglu et al 13 found that a single intraoperative dose of i.v. paracetamol (15 mg/kg) decreased the severity of CRBD and total meperidine administration.…”

“…These treatments included muscarinic antagonists, 1,[5][6][7][8]15 anesthetics, [9][10][11] antiepileptics, 3,4,14 and analgesics. 12,13 Description of effective treatments Anticholinergic agents and antiepileptics administered 1 hour before surgery reduced the incidence and severity of CRBD. Tramadol and ketamine are centrally acting opioid analgesics with antimuscarinic actions, which effectively prevent CRBD when administered intravenous (i.v.).…”

“…20 Therefore, paracetamol, a PG synthesis and COX-2 inhibitor, may alleviate the occurrence and symptoms of CRBD. 13 In addition, calcitonin gene-related peptide (CGRP) nerve fibers, which regulate the immune system, were located in bladder smooth muscle and more densely distributed in the neck compared with the dome. 21 Recently, CGRP has shown to be associated with inflammation and venular relaxation.…”

“…14 In addition, paracetamol had sedative properties. 13 However, the patients treated with paracetamol were less agitated and anxious in their early recovery. As such, none of the patients exhibited hypotension, hypertension, or arrhythmia.…”