Evaluation of intra-operative tramadol for prevention of catheter-related bladder discomfort: a prospective, randomized, double-blind study
Evaluation of intra-operative tramadol for prevention of catheter-related bladder discomfort: a prospective, randomized, double-blind study
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DOI：
10.1093/bja/aen217
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发表时间：
2008-10-01
影响因子：
9.8
通讯作者：
Singh, U.
中科院分区：
文献类型：
--
作者：
Agarwal, A.;Yadav, G.;Singh, U.
背景。导管相关性膀胱不适 (CRBD) 被定义为排尿冲动或耻骨上区不适；术中接受导尿术的患者术后报告。我们评估了曲马多（一种中枢作用的阿片类镇痛药，具有毒蕈碱受体拮抗剂特性）用于预防 CRBD。方法。 54 名成人（18-60 岁），ASA 身体状况 I 级和 II 级，性别不限，接受择期经皮肾镜取石术，随机分为两组，每组 27 人。对照组(C)组接受生理盐水(NS；2ml)，而曲马多(T)组接受曲马多1.5mg·kg(-1)。所有药物均稀释在 2 ml NS 中，并在拔管前 30 分钟给药。术中使用16 Fr Foley导管进行导尿，并用10 ml蒸馏水对球囊进行充气。在患者到达麻醉后护理室后 0、1、2 和 6 小时评估 CRBD 以及术后芬太尼总需求量。 CRBD的严重程度分为无、轻度、中度和重度。通过单向方差分析、Z 检验和 Fisher 精确检验对数据进行分析。 P < 0.05 被认为是显着的。结果。与C组相比，T组各时间点CRBD的发生率和严重程度均降低（P < 0.05）。与C组[210(34.6)]相比，T组[176(sd 26.5)]术后疼痛视觉模拟评分和术后芬太尼总需求量(μ g kg(-1))也减少(P < 0.05)。结论。静脉注射曲马多 1.5 mg kg(-1)拔管前 30 分钟可降低 CRBD 的发生率和严重程度以及术后芬太尼的需求。
Background. Catheter-related bladder discomfort (CRBD) is defined as an urge to void or discomfort in the supra-pubic region; reported postoperatively in patients who have had urinary catheterization intra-operatively. We have evaluated tramadol, a centrally acting opioid analgesic with muscarinic receptor antagonist properties for prevention of CRBD.Methods. Fifty-four adults (18-60 yr), ASA physical status I and II of either sex, undergoing elective percutaneous nephro-lithomy were randomly divided into two groups of 27 each. Control (C) group received normal saline (NS; 2 ml), whereas Tramadol (T) group received tramadol 1.5 mg kg(-1). All medications were diluted in 2 ml NS and administered 30 min before extubation. Intra-operatively, urinary catherization was performed with a 16 Fr Foley's catheter, and the balloon was inflated with 10 ml distilled water. The CRBD was assessed at 0, 1, 2, and 6 h after patient's arrival in the post-anaesthesia care unit along with total postoperative fentanyl requirement. Severity of CRBD was graded as none, mild, moderate and severe. Data were analysed by one-way anova, Z-test, and Fisher's exact test. P < 0.05 was considered significant.Results. Incidence and severity of CRBD was reduced in T group compared with C group at all time points (P < 0.05). Postoperative pain as assessed by visual analogue scale and total postoperative fentanyl requirement (mu g kg(-1)) was also reduced in the T group [176 (sd 26.5)] compared with C group [210 (34.6)] (P < 0.05).Conclusions. Tramadol 1.5 mg kg(-1) administered i.v. 30 min before extubation decreases the incidence and severity of CRBD and postoperative fentanyl requirement.