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The effect of intraoperative dexmedetomidine on postoperative catheter-related bladder discomfort in patients undergoing transurethral bladder tumour resection

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Author(s)
Hyun-Chang KimYong-Hun LeeYoung-Tae JeonJung-Won HwangYoung-Jin LimJung-Eun ParkHee-Pyoung Park
Keimyung Author(s)
Kim, Hyun Chang
Department
Dept. of Anesthesiology & Pain Medicine (마취통증의학)
Journal Title
European Journal of Anaesthesiology
Issued Date
2015
Volume
32
Issue
9
Abstract
BACKGROUND Catheter-related bladder discomfort
(CRBD) due to an indwelling urinary catheter causes postoperative
distress. Dexmedetomidine is used as an anaesthetic
adjuvant during general anaesthesia and has an
antimuscarinic effect, which may be beneficial for the prevention
and treatment of CRBD.
OBJECTIVE To determine the effect of intraoperative dexmedetomidine
administration on the incidence of CRBD.
DESIGN A double-blind, placebo-controlled, randomised
study.
SETTING A tertiary care teaching hospital.
PATIENTS One-hundred and nine patients undergoing
transurethral bladder tumour excision (TURB).
INTERVENTIONS Patients were randomly allocated to two
groups: control group (n¼55) received placebo and dexmedetomidine
group (n¼54) received intraoperative dexmedetomidine
(1mgkg 1 loading dose followed by
0.5mgkg 1 h 1continuous infusion).
MAIN OUTCOME MEASURES The incidence and severity
(mild, moderate, severe) of CRBD assessed at 0, 1, 6 and
24 h postoperatively.
RESULTS The incidence of CRBD was significantly higher in
the control group at 0 (78 vs. 50%; P¼0.004), 1 (86 vs.
57%; P¼0.002) and 6 h (82 vs. 63%; P¼0.047) postoperatively.
The incidence of moderate to severe CRBD was
higher in the control group at 0 (38 vs. 11%; P¼0.002) and
1 h (29 vs. 7%; P¼0.006) postoperatively. The number of
patients having CRBD treated with tramadol was higher in
the control group (24 vs. 12; P¼0.006). The mean end-tidal
desflurane concentration during the surgery was higher in
the control group (4.5 vs. 3.9%; P¼0.04). The postoperative
pain score (numerical rating scale: 0 to 10) was higher in the
control group at 0 (4.6 vs. 2.7; P¼0.002), and 1 h (3.8 vs.
2.7; P¼0.041). The number of patients treated with opioids
was higher in the control group (21 vs. 8; P¼0.011).
CONCLUSION Intraoperative dexmedetomidine administration
decreased the incidence and severity of early postoperative
CRBD as well as intraoperative desflurane and
postoperative opioid requirements in patients undergoing
TURB.
Keimyung Author(s)(Kor)
김현창
Publisher
School of Medicine
Citation
Hyun-Chang Kim et al. (2015). The effect of intraoperative dexmedetomidine on postoperative catheter-related bladder discomfort in patients undergoing transurethral bladder tumour resection. European Journal of Anaesthesiology, 32(9), 596–601. doi: 10.1097/EJA.0000000000000196
Type
Article
ISSN
0265-0215
Source
http://lps3.insights.ovid.com.proxy.dsmc.or.kr/pubmed?pmid=25485879
DOI
10.1097/EJA.0000000000000196
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33056
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Anesthesiology & Pain Medicine (마취통증의학)
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