Preoperative education with image illustrations enhances the effect of tetracaine mucilage in alleviating postoperative catheter-related bladder discomfort: a prospective, randomized, controlled study

Abstract

BackgroundCatheter-related bladder discomfort (CRBD), secondary to catheterization of urinary bladder is distressing. The aim of this study was to assess the efficacy of preoperative education on CRBD with image illustration for alleviating CRBD.MethodsSixty adult male patients, undergoing elective colonal and rectal surgery, were randomized to receive tetracaine mucilage instilled into the urethra and applied to the catheter (tetracain group), or receive tetracaine mucilage in combination with image illustration on CRBD (image group) before urethral catheterization. The incidence and severity of CRBD were assessed at 0.5, 1, 2, and 6 h after patients’ extubation. The severity of postoperative pain, incidence of postoperative agitation and other adverse events were also recorded.ResultsPatients in image group reported remarkably less CRBD than those in tetracaine group at 0.5,1, 2 and 6 h after extubation (20, 20, 6.7 and 6.7% v.s. 60, 73.3, 53.3 and 53.3%, respectively, P<0.01). Severe CRBD was not reported in either group. However, the incidence of moderate CRBD was significantly lower in image group, with 6.7% at 1 h and thereafter none occurred, compared to 6.7% at 0.5 h, and increasing to 20% at 1 h, 2 h and 6 h in tetracaine group, respectively. Moreover, patients in image group suffered less moderate to severe postoperative pain than that of tetracaine group (13.3% v.s. 40.0% at 1 h, P = 0.039, 33.3% v.s. 60% at 2 h and 6 h, P = 0.038).ConclusionsPreoperative education on uretheral catheterization via image illustrations could enhance the effect of tetracaine mucilage in reducing both the incidence and severity of CRBD.Trial registrationThe trial was registered at www,clinicaltrials.gov with registration number NCT03199105 (retrospectively registered). Date of trial registration which is “June 26, 2017”.Electronic supplementary materialThe online version of this article (10.1186/s12871-018-0653-y) contains supplementary material, which is available to authorized users.

Magnesium and Bladder Discomfort after Transurethral Resection of Bladder Tumor

“…4 In particular, rescue treatments are needed for patients who experience catheter-related bladder discomfort above a moderate grade, which occurs in 38 to 57% of patients in the PACU. 4,25,26 Unlike postoperative somatic pain, opioid administration may be regarded as ineffective to manage catheter-related bladder discomfort considering the mechanisms underlying catheter-related bladder discomfort. 27 One mechanism underlying the occurrence of catheter-related bladder discomfort is the activation of muscarinic acetylcholine receptors by the simulation of the urinary bladder catheter.…”

Acceptance of Supportive Illustrations for Preparation of Patients for an Orthopedic Telemedical Consultation

“…This will be most likely based on the knowledge conveyed by the illustrations. Increased knowledge can in turn have a positive effect on the doctor–patient communication with less uncertainties regarding an OTC ( 9 , 17 ). Since the two groups differed significantly in this respect, it may be postulated that the Nov-group believed that an OTC was simple to conduct even without prior information.…”

“…But there are also studies with different results regarding the acceptance of the provision of information prior to a medical consultation (15,16). Also, practical medical impacts could be shown, when for example, preoperative illustrations before a catheterization of the urinary bladder could reduce the incidence and the severity of catheterrelated bladder discomfort (17). As even the NOV-group stated that they could imagine the illustrations to be helpful for the preparation for an assumed OTC, this may support a potential success of such offers on patients, regardless of a prior OTC experience (15).…”

“…Some studies reported a very positive attitude of patients toward telemedical consultations in trauma surgery due to lower costs, reduced travel time, or less need for childcare (15), whereas other groups found contrary results (16). However, a positive attitude toward telemedicine is an essential prerequisite for good digital communication between physicians and patients, and it can be increased essentially by knowledge about the processes (9,17). Illustrations explaining the procedure have already been established in telemedicine to increase the understanding and acceptance of patients (18).…”

“…In patients with infectious or chronic diseases, illustrations were able to support the adherence to instructions on specific behaviors ( 20 , 21 ). Illustrations have also proven to be helpful in preparation before an intervention, also concerning the incidence and severity of consequences or complications of the intervention ( 17 ). However, data regarding the usefulness of illustrations concerning telemedical consultations in orthopedic and trauma surgery are still lacking.…”