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

Abstract

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.

Neostigmine for postoperative surgical urine retention: A systematic review and meta-analysis

“…The primary features of the 14 clinical studies [16][17][18][19][20][21][22][23][24][25][26][27][28][29] are outlined in Table 1. The publication dates ranged from 2000 to 2023.…”

“…Table 3 displays the findings of the primary outcomes, including the volume of urine expelled [mL], reported in 3 studies, 16,17,29 and the reduction in POUR, reported in 11 studies. [18][19][20][21][22][23][24][25][26][27][28]…”

“…14,15 The data suggest that further research is required to explore the utilization of neostigmine for POUR. Consequently, pertinent publications [16][17][18][19][20][21][22][23][24][25][26][27][28][29] were procured and reviewed to conduct a thorough investigation into the efficacy of neostigmine in POUR.…”