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

Park, Jun-Young; Hong, Jun Hyuk; Yu, Jihion; Kim, Doo-Hwan; Koh, Gi-Ho; Lee, Sang‐Ah; Hwang, Jai‐Hyun; Kong, Yu-Gyeong; Kim, Young‐Kug

doi:10.3390/jcm8060759

Cited by 22 publications

(27 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[8][9][10][26][27][28][29][30][31] Another mechanism underlying the occurrence of catheter-related bladder discomfort was found to be mediated by an increased urinary concentration of prostaglandin. 30,31 Urinary catheter and mucosal injury could induce local inflammation with activation of the cyclooxygenase pathway and release of prostaglandin. 32,33 Antiinflammatory agents such as paracetamol and ketorolac are known to be effective in the management of postoperative catheter-related bladder discomfort (table 6).…”

Section: Discussionmentioning

confidence: 99%

Magnesium and Bladder Discomfort after Transurethral Resection of Bladder Tumor

et al. 2020

Self Cite

View full text Add to dashboard Cite

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

show abstract

Section: Discussionmentioning

confidence: 99%

Magnesium and Bladder Discomfort after Transurethral Resection of Bladder Tumor

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…All patients were questioned about their symptoms of CRBD by investigators in the PACU and surgical ward. The severity of CRBD was assessed with a 4-point scale: none (no discomfort when asked); mild (reported by the patient only when asked); moderate (reported by patient without being asked and without any behavioral response); or severe (reported by the patient independently along with behavioral responses such as ailing limbs, strong vocalization, and attempts to remove the catheter) 5,13,14 . The severity of CRBD was scaled using the methods described above.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Unilateral Ilioinguinal Transversus Abdominis Plane Block for Alleviation of Catheter-related Bladder Discomfort in Male Patients after Emergence from General Anesthesia: a Prospective, Randomized Controlled Trial

Zhao¹,

Wang²,

Hu³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Urinary catheterization frequently leads to catheter-related bladder discomfort (CRBD) in male patients after general anesthesia. This prospective cohort trial aimed to prove the efficacy of unilateral ilioinguinal transversus abdominis plane block (TAPB) in attenuating CRBD in male patients. Methods: Male patients with a severe CRBD were randomized to receive unilateral ilioinguinal TAPB with 0.375% ropivacaine 10 mL (group T) or intravenous sufentanil 0.15 μg/kg (group C). The primary outcomes were the incidence rates of moderate-to-severe CRBD at 0.5, 1, 2, and 6 hours after treatment, and the other outcomes were postoperative adverse events related to treatments. Results: The incidence rates of moderate-to-severe CRBD were significantly lower in group T than in group C at 0.5 hours (11.5% vs 87.4%, P<0.001), 1 hour (7.6% vs 92.3%, P=0.001), 2 hours (7.6% vs 92.3%, P=0.001), and 6 hours (11.5% vs 100%, P<0.001) after treatment. The postoperative incidences of sedation and respiratory depression were decreased significantly in group T compared to group C (P<0.05). Conclusions: Unilateral ilioinguinal TAPB with ropivacaine can decrease the incidence of moderate-to-severe CRBD and reduce side effects in male patients after general anesthesia compared to intravenous sufentanil administration. Trial registration: This trial was registered with Clinicaltrials.gov as ChiCTR1900022869 on April 29, 2019, http://www.chictr.org.cn/showproj.aspx?proj=38516.

show abstract

“…Importantly, CRBD is a known risk factor of emergence agitation in the PACU, and 47-90% of patients complain of CRBD during the postoperative period [28]. In particular, moderate-to-severe CRBD, which may need urgent management, occurs in 50-67% of patients at the PACU after undergoing urologic surgery [3,4]. Moreover, the incidence of postoperative complications, such as surgical wound dehiscence, postoperative bleeding, or increased severity of coronary artery disease, may increase because of the symptoms of CRBD, which may consequently prolong hospital stay [27].…”

Section: Discussionmentioning

confidence: 99%

“…Urinary catheterization is generally performed at the end of RIRS to facilitate urination and assess hematuria in patients undergoing this surgery [2]. Catheter-related bladder discomfort (CRBD) is characterized by elevated symptoms of urinary frequency and urgency as well as suprapubic area discomfort caused by the urinary catheter [3][4][5]. Moderate-to-severe CRBD can be extremely distressing to the patient and may cause reduced quality of postoperative care at the postanesthetic care unit (PACU) and necessitate additional therapy for CRBD [6,7].…”

Section: Introductionmentioning

confidence: 99%

Effect of sugammadex versus glycopyrrolate–neostigmine mixture on catheter-related bladder discomfort after retrograde intrarenal surgery: A retrospective observational analysis

Koh

Park

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Catheter-related bladder discomfort (CRBD) is one of the most common postoperative symptoms. Although sugammadex and glycopyrrolate–neostigmine mixture are both used for the reversal of neuromuscular blockade, their effects on CRBD have not been compared side-to-side. We investigated the effect of the neuromuscular blockade reversal agents on CRBD after urologic surgery. Methods: We retrospectively reviewed the medical records of 136 patients who underwent retrograde intrarenal surgery between July 2018 and January 2019. Patients were divided into the S group (sugammadex; n = 65) and the G group (glycopyrrolate–neostigmine mixture; n = 71). Primary outcome was moderate-to-severe CRBD at 0 h postoperatively. We also evaluated moderate-to-severe CRBD at 1, 2, and 6 h postoperatively, duration of postanesthetic care unit (PACU) stay, postoperative pain, postoperative analgesic requirement, and drug-related side effects. Results: The incidence of moderate-to-severe CRBD at 0 h postoperatively was significantly lower in the G group than in the S group (39.4% vs. 69.2%, p = 0.001). The two groups did not show significant differences in the incidences of moderate-to-severe CRBD at 1, 2, and 6 h postoperatively, postoperative pain, and postoperative analgesic requirement. The duration of PACU stay was significantly shorter in the G group (46.0 min vs. 53.0 min, p = 0.047). Except for dry mouth, drug-related side effects did not show significant differences between the two groups. Conclusion: Compared with sugammadex, glycopyrrolate–neostigmine mixture was associated with a lower incidence of CRBD immediately after urologic surgery and shorter PACU stay.

show abstract

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

Cited by 22 publications

References 49 publications

Magnesium and Bladder Discomfort after Transurethral Resection of Bladder Tumor

Magnesium and Bladder Discomfort after Transurethral Resection of Bladder Tumor

Efficacy of Unilateral Ilioinguinal Transversus Abdominis Plane Block for Alleviation of Catheter-related Bladder Discomfort in Male Patients after Emergence from General Anesthesia: a Prospective, Randomized Controlled Trial

Effect of sugammadex versus glycopyrrolate–neostigmine mixture on catheter-related bladder discomfort after retrograde intrarenal surgery: A retrospective observational analysis

Contact Info

Product

Resources

About