Magnesium and Bladder Discomfort after Transurethral Resection of Bladder Tumor

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

Intravesical dexmedetomidine instillation reduces postoperative catheter-related bladder discomfort in male patients under general anesthesia: a randomized controlled study

“…CRBD is common in PACU, especially male patients [26]. Therefore, in this study, we included male patients as the study subject, and the incidence of CRBD was 65.2%, which was consistent with that reported previously [1,2,26]. The high incidence of CRBD in male patients might be related to the anatomical characteristics, such as the long urethra and large catheter [26].…”

“…Catheter-related bladder discomfort (CRBD) after the operation is a common adverse reaction; however, many surgery patients need an indwelling catheter during or after the operation. The incidence of CRBD is 47-90% [1,2], and catheter maladjustment is common, especially in male patients [3,4]. Reportedly, 27-55% of the patients experience moderate or severe catheter-related bladder discomfort symptoms in the post-anesthesia care unit (PACU) [3,5].…”

Dexmedetomidine intravesical instillation reduces postoperative catheter-related bladder discomfort in male patients under general anesthesia: a randomized controlled study

“…CRBD is common in PACU, especially male patients [26]. Therefore, in this study, we included male patients as the study subject, and the incidence of CRBD was 64.5%, which was consistent with that reported previously [1,2,26]. The high incidence of CRBD in male patients might be related to the anatomical characteristics, such as the long urethra and large catheter [26].…”

“…Background Catheter-related bladder discomfort (CRBD) after the operation is a common adverse reaction; however, many surgery patients need an indwelling catheter during or after the operation. The incidence of CRBD is 47-90% [1,2], and catheter maladjustment is common, especially in male patients [3,4]. Reportedly, 27-55% of the patients experience moderate or severe catheter-related bladder discomfort symptoms in the post-anesthesia care unit (PACU) [3,5].…”

Intravesical dexmedetomidine instillation reduces postoperative catheter-related bladder discomfort in male patients under general anesthesia: a randomized controlled study

“…Catheter-related bladder discomfort (CRBD) after the operation is a common adverse reaction; however, many surgery patients need an indwelling catheter during or after the operation. The incidence of CRBD is 47-90% [1,2], and catheter maladjustment is common, especially in male patients [3,4].…”