Evaluation of efficacy of amikacin for attenuation of catheter-related bladder discomfort in patients undergoing percutaneous nephrolithotomy: A prospective, randomized, placebo-controlled, double-blind study

Abstract

Context:Catheter-related bladder discomfort (CRBD) is the most distressing symptom in patients due to intraoperative urinary catheterization. Amikacin significantly inhibits detrusor contraction evoked by prejunctional stimulation.Aims:The aim of this study is to evaluate the efficacy of amikacin in prevention of CRBD in patients undergoing percutaneous nephrolithotomy.Settings and Design:Study areas were operation theater and postanesthesia care unit of the Department of Anesthesiology, SGPGIMS, Lucknow.Subjects and Methods:One hundred adult patients of either sex were randomly assigned into two groups of fifty each. Patients in control group received normal saline whereas patients in amikacin group received amikacin 10 mg/kg just before induction. Grading of CRBD was done as none, mild, moderate, and severe by a blinded observer at 0, 1, 6, 12, and 24 h after surgery.Statistical Analysis Used:Data were analyzed using Student's t-test and Chi-square test among groups. Incidence of CRBD was compared with Chi-square test whereas severity was analyzed by the test of proportions (Z-test). Visual analog score was compared using Mann–Whitney U-test for surgical site pain.Results:Incidence of CRBD in control group was 66% as compared to 44% observed in amikacin group (P < 0.05). During intergroup comparison at different time points, incidence of CRBD was reduced at 1 and 6 h in the amikacin group (P < 0.05). Significant reduction in the severity of CRBD (moderate) was also observed at 1 h in the amikacin group (P < 0.05). At rest of the time points, there was no significant difference.Conclusions:Amikacin can significantly reduce the incidence and severity of CRBD in the first few hours after surgery.

Pharmacological interventions for reducing catheter-related bladder discomfort in patients undergoing elective surgeries under general anaesthesia: A systematic review and meta-analysis

“…A prospective, randomised, double-blinded, placebo-controlled trial conducted by Verma R et al , in 2021[ 20 ] evaluated the efficacy of intravenous amikacin (10 mg/kg) for the attenuation of CRBD in 100 patients undergoing percutaneous nephrolithotomy under general anaesthesia. A 16 French Foley catheter was utilised for catheterisation of the urinary bladder.…”

“…[ 12 ] The study on amikacin was able to provide a statistically significant difference only in the first hour postoperatively. [ 20 ] The study on diphenhydramine implied a reduction in the incidence of CRBD at 2 hours and 6 hours after surgery and absolute risk reduction came to be 24%. [ 19 ]…”