Jendoubi Ali, Aissi Wafa, Abbes Ahmed, Bouzouita Abderrazek, Fourati Sami, Necib Hatem, Ghedira Salma, Houissa Mohamed
Department of Anaesthesia and Intensive Care, Faculty of Medicine of Tunis, Charles Nicolle Hospital of Tunis, University of Tunis El Manar, Tunis, Tunisia.
Department of Medical Epidemiology, Pasteur Institute of Tunis, Tunis, Tunisia.
Indian J Anaesth. 2018 Jun;62(6):461-465. doi: 10.4103/ija.IJA_137_18.
Catheter-related bladder discomfort (CRBD) is the urge to void or discomfort in the suprapubic region secondary to an indwelling urinary catheter. We aimed to evaluate the safety and efficacy of single-dose of intravenous parecoxib in reducing the incidence and severity of CRBD in patients undergoing transurethral resection of bladder tumor (TURBT).
Sixty-one adult patients, American Society of Anesthesiologists physical status I or II, undergoing elective TURBT under spinal anaesthesia, were randomly allocated to receive 40 mg of IV parecoxib (group P; = 29) or an equal volume of normal saline (control group C; = 32). CRBD was graded as none, mild, moderate, and severe. Between-group comparisons were made for the incidence and severity of CRBD, postoperative Visual analog scales (VAS), rescue analgesia equirements, and occurrence of adverse events. Statistical analysis done with the Mann-Whitney U-test and Fisher's Exact Test. A value of ≤ 0.05 was considered statistically significant.
Parecoxib significantly reduced the incidence and severity of CRBD at 2, 4, 6, and 12 hours postoperatively compared to placebo ( < 0.05). Median pain VAS scores were lower in the group at all times except the first hour. Rescue analgesia was given to more patients in group C (16/32, 50%) than in group P (1/29) ( < 0.001). None of the patients who received parecoxib experienced an adverse event.
A single intravenous injection of parecoxib is safe and effective in decreasing the incidence and severity of CRBD in patients undergoing TURBT.
NCT02729935(www.clinicaltrials.gov).
导尿管相关膀胱不适(CRBD)是指留置导尿管继发的排尿冲动或耻骨上区不适。我们旨在评估单剂量静脉注射帕瑞昔布在降低膀胱肿瘤经尿道切除术(TURBT)患者CRBD发生率和严重程度方面的安全性和有效性。
61例美国麻醉医师协会身体状况分级为I或II级、接受脊髓麻醉下择期TURBT的成年患者,被随机分配接受40mg静脉注射帕瑞昔布(P组;n = 29)或等体积生理盐水(对照组C;n = 32)。CRBD分为无、轻度、中度和重度。对CRBD的发生率和严重程度、术后视觉模拟量表(VAS)、补救镇痛需求及不良事件的发生情况进行组间比较。采用Mann-Whitney U检验和Fisher精确检验进行统计分析。P值≤0.05被认为具有统计学意义。
与安慰剂相比,帕瑞昔布在术后2、4、6和12小时显著降低了CRBD的发生率和严重程度(P < 0.05)。除第1小时外,P组在所有时间点的疼痛VAS评分中位数均较低。C组接受补救镇痛的患者(16/32,50%)多于P组(1/29)(P < 0.001)。接受帕瑞昔布的患者均未发生不良事件。
单次静脉注射帕瑞昔布在降低TURBT患者CRBD的发生率和严重程度方面是安全有效的。
NCT02729935(www.clinicaltrials.gov)。