Nam Karam, Seo Jeong-Hwa, Ryu Jung-Hee, Oh Ah-Young, Lee Taeseung, Park Hee-Pyoung, Jeon Young-Tae, Hwang Jung-Won
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea.
Surgery. 2015 Feb;157(2):396-401. doi: 10.1016/j.surg.2014.05.017. Epub 2014 Oct 8.
Postoperative catheter-related bladder discomfort (CRBD) can be a distressing complication for patients in whom a urinary catheter was inserted during an operation. Our randomized, dual-center, clinical trial investigated the effects of butylscopolamine on the prevention of postoperative CRBD in patients undergoing various operations.
Adult male patients undergoing elective operations requiring intraoperative urinary catheterization under general anesthesia were enrolled. They were assigned randomly to 2 groups: The butylscopolamine group (n = 49) received 20 mg of butylscopolamine intravenously immediately before the end of the operation; no medication was given for prevention of CRBD in the control group (n = 50). The presence and severity of CRBD were assessed at 1, 2, and 6 hours postoperatively. Adverse effects of butylscopolamine were also examined.
The overall incidence of CRBD was less in the butylscopolamine group than in the control group (31% vs 66%, respectively; P = .001). The incidence of CRBD at 1, 2, and 6 hours postoperatively was also less in the butylscopolamine group (P = .006, .04, and .048, respectively). In addition, the average severity of CRBD for 6 hours postoperatively was significantly less in the butylscopolamine group than in the control group (median, 0 [interquartile range, 0-17] vs 22 [interquartile range, 0-47], respectively; P = .002). Adverse effects were comparable between the 2 groups.
Intravenous administration of butylscopolamine at the end of an operation decreases effectively the incidence and severity of early postoperative CRBD without adverse effects.
术后导尿管相关膀胱不适(CRBD)对于手术中插入导尿管的患者而言可能是一种令人痛苦的并发症。我们的随机、双中心临床试验研究了丁溴东莨菪碱对接受各类手术患者预防术后CRBD的效果。
纳入成年男性择期手术患者,这些患者在全身麻醉下需要术中导尿。他们被随机分为2组:丁溴东莨菪碱组(n = 49)在手术结束前立即静脉注射20 mg丁溴东莨菪碱;对照组(n = 50)未给予预防CRBD的药物。术后1、2和6小时评估CRBD的发生情况及严重程度。同时也检查了丁溴东莨菪碱的不良反应。
丁溴东莨菪碱组CRBD的总体发生率低于对照组(分别为31%和66%;P = .001)。丁溴东莨菪碱组术后1、2和6小时CRBD的发生率也较低(分别为P = .006、.04和.048)。此外,丁溴东莨菪碱组术后6小时CRBD的平均严重程度明显低于对照组(中位数分别为0[四分位间距,0 - 17]和22[四分位间距,0 - 47];P = .002)。两组间不良反应相当。
手术结束时静脉注射丁溴东莨菪碱可有效降低术后早期CRBD的发生率和严重程度,且无不良反应。