Preoperative Belladonna and Opium Suppository for Ureteral Stent Pain: A Randomized, Double-blinded, Placebo-controlled Study
Preoperative Belladonna and Opium Suppository for Ureteral Stent Pain: A Randomized, Double-blinded, Placebo-controlled Study
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DOI：
10.1016/j.urology.2016.07.035
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发表时间：
2017-02-01
期刊：
影响因子：
2.1
通讯作者：
Harper, Jonathan D.
中科院分区：
文献类型：
--
作者：
Lee, Franklin C.;Holt, Sarah K.;Harper, Jonathan D.
目的探讨在输尿管镜检查（URS）和支架置入术前立即使用颠茄和鸦片（B&O）直肠栓剂是否可以减少支架相关不适。方法2013年8月至2014年12月进行了一项随机、双盲、安慰剂对照研究。71名受试者入组并随机接受B&O（15 mg/30 mg）或安慰剂栓剂诱导全身麻醉后立即URS和支架置入术。使用美国泌尿外科协会症状评分（AUASS）评估基线泌尿系统症状。在术后（POD）第1、3天和支架取出后完成输尿管支架症状问卷和AUASS。术中，在恢复单位，并在家里使用镇痛剂recorded.Results的71例，65例输尿管（41%）和肾（61%）结石，4肾尿路上皮癌，2例被排除在没有支架放置治疗。到POD 3时，B&O组的平均总体生活质量（QOL）评分较高（P = 0.04），平均工作质量评分较好（P = 0.05），排尿疼痛较轻（P = 0.03）。B&O组报告了POD 1与支架取出后相比AUASS QOL的改善（P = 0.04）。组间镇痛药使用无差异（P = 0.67）。未发生尿潴留。年龄与计划外急诊就诊相关（P
OBJECTIVE To investigate whether the use of a belladonna and opium (B&O) rectal suppository administered immediately before ureteroscopy (URS) and stent placement could reduce stent-related discomfort.METHODS A randomized, double-blinded, placebo-controlled study was performed from August 2013 to December 2014. Seventy-one subjects were enrolled and randomized to receive a B&O (15 mg/30 mg) or a placebo suppository after induction of general anesthesia immediately before URS and stent placement. Baseline urinary symptoms were assessed using the American Urological Association Symptom Score (AUASS). The Ureteral Stent Symptom Questionnaire and AUASS were completed on postoperative days (POD) 1, 3, and after stent removal. Analgesic use intra-operatively, in the recovery unit, and at home was recorded.RESULTS Of the 71 subjects, 65 had treatment for ureteral (41%) and renal (61%) calculi, 4 for renal urothelial carcinoma, and 2 were excluded for no stent placed. By POD3, the B&O group reported a higher mean global quality of life (QOL) score (P = .04), a better mean quality of work score (P = .05), and less pain with urination (P = .03). The B&O group reported an improved AUASS QOL when comparing POD1 with post-stent removal (P = .04). There was no difference in analgesic use among groups (P = .67). There were no episodes of urinary retention. Age was associated with unplanned emergency visits (P