Efficacy of a novel urinary catheter for men with a local anesthetic injection port for catheter-related bladder discomf
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ORIGINAL ARTICLE
Efficacy of a novel urinary catheter for men with a local anesthetic injection port for catheter‑related bladder discomfort: a randomized controlled study Hidekazu Imai1 · Yutaka Seino1 · Hiroshi Baba1 Received: 10 April 2020 / Accepted: 30 May 2020 © Japanese Society of Anesthesiologists 2020
Abstract Purpose The NMOC-3WAY c atheter® is a novel urinary catheter for men that can be used to inject a local anesthetic into the urethra. We sought to assess whether the injection of a local anesthetic into the urethra via the NMOC-3WAY catheter® would reduce catheter-related bladder discomfort (CRBD) after endovascular aneurysm repair (EVAR). Methods Adult male patients who underwent elective EVAR for abdominal aortic aneurysms were randomly assigned to the 2% lidocaine group and the normal saline group (control group). CRBD was evaluated at 0, 1, 2, 4, and 6 h after surgery. The primary outcome was the incidence of CRBD at 0 h after surgery. Results Data for 37 patients (19 in the lidocaine group and 18 in the control group) were analyzed. CRBD was observed at 0 h in six patients (31.6%; mild, n = 5; moderate, n = 1) in the lidocaine group and in five patients (27.8%; mild, n = 1; moderate, n = 3; severe, n = 1) in the control group. The control group showed a tendency to have severe CRBD at 0 h, although there was no significant difference in either the incidence (P = 0.80) or severity (P = 0.21) of CRBD between the two groups. Conclusion Our results suggest that the use of the NMOC-3WAY c atheter® for the injection of 2% lidocaine into the urethra does not reduce the incidence of CRBD immediately after EVAR. However, it may reduce moderate or severe CRBD that may lead to postoperative distress and agitation. Keywords NMOC-3WAY catheter® · Catheter-related bladder discomfort · Local anesthetic
Introduction Patients with a urinary catheter during surgery frequently complain of catheter-related bladder discomfort (CRBD) with varying degrees of severity during the immediate postoperative period. In particular, male patients complain of moderate or severe CRBD more frequently [1]. CRBD is defined as a burning sensation with an urge to void or as discomfort in the suprapubic area caused by bladder irritation due to a urinary catheter [2]. This discomfort may lead to postoperative distress and agitation [3]. The mechanism underlying CRBD is similar to that of an overactive bladder and the muscarinic receptors are closely related to CRBD * Hidekazu Imai [email protected]‑u.ac.jp 1
Department of Anesthesiology, Niigata University Graduate School of Medical and Dental Sciences, 1‑757 Asahimachi‑dori, Chuo‑ku, Niigata 951‑8510, Japan
[2]. In previous studies, various agents, including gabapentin [4], pregabalin [5], oxybutynin [6], tolterodine [2], ketamine [7, 8], tramadol [9], and dexmedetomidine [10], have been reported to reduce the incidence and severity of postoperative CRBD. However, the use of these agents for the treatment of CRBD can cause postoperative side effects, including dry
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