Zhou Li, Zhou Le, Tian Leilei, Zhu Daojun, Chen Ziwen, Zheng Chang, Zhou Ting, Zeng Xianzheng, Jiang Xiaojuan, Jiang Chunling, Bo Lulong
Department of Anaesthesiology and Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Department of Anaesthesiology, Sichuan Jinxin Women and Children's Hospital, Chengdu, 610011, Sichuan, China.
BMC Anesthesiol. 2018 Dec 22;18(1):204. doi: 10.1186/s12871-018-0653-y.
Catheter-related bladder discomfort (CRBD), secondary to catheterization of urinary bladder is distressing. The aim of this study was to assess the efficacy of preoperative education on CRBD with image illustration for alleviating CRBD.
Sixty adult male patients, undergoing elective colonal and rectal surgery, were randomized to receive tetracaine mucilage instilled into the urethra and applied to the catheter (tetracain group), or receive tetracaine mucilage in combination with image illustration on CRBD (image group) before urethral catheterization. The incidence and severity of CRBD were assessed at 0.5, 1, 2, and 6 h after patients' extubation. The severity of postoperative pain, incidence of postoperative agitation and other adverse events were also recorded.
Patients in image group reported remarkably less CRBD than those in tetracaine group at 0.5,1, 2 and 6 h after extubation (20, 20, 6.7 and 6.7% v.s. 60, 73.3, 53.3 and 53.3%, respectively, P<0.01). Severe CRBD was not reported in either group. However, the incidence of moderate CRBD was significantly lower in image group, with 6.7% at 1 h and thereafter none occurred, compared to 6.7% at 0.5 h, and increasing to 20% at 1 h, 2 h and 6 h in tetracaine group, respectively. Moreover, patients in image group suffered less moderate to severe postoperative pain than that of tetracaine group (13.3% v.s. 40.0% at 1 h, P = 0.039, 33.3% v.s. 60% at 2 h and 6 h, P = 0.038).
Preoperative education on uretheral catheterization via image illustrations could enhance the effect of tetracaine mucilage in reducing both the incidence and severity of CRBD.
The trial was registered at www,clinicaltrials.gov with registration number NCT03199105 (retrospectively registered). Date of trial registration which is "June 26, 2017".
导尿引起的导管相关性膀胱不适（CRBD）令人痛苦。本研究旨在评估术前通过图像演示进行教育对缓解CRBD的效果。
60例择期行结肠和直肠手术的成年男性患者，随机分为两组，一组在尿道插管前接受将丁卡因黏液注入尿道并涂抹于导管（丁卡因组），另一组接受丁卡因黏液并结合CRBD图像演示（图像组）。在患者拔管后0.5、1、2和6小时评估CRBD的发生率和严重程度。记录术后疼痛的严重程度、术后躁动的发生率及其他不良事件。
拔管后0.5、1、2和6小时，图像组患者报告的CRBD明显少于丁卡因组（分别为20%、20%、6.7%和6.7%对60%、73.3%、53.3%和53.3%，P<0.01）。两组均未报告严重CRBD。然而，图像组中度CRBD的发生率显著较低，1小时时为6.7%，此后未再发生，而丁卡因组0.5小时时为6.7%，1、2和6小时时分别增至20%。此外，图像组患者术后中度至重度疼痛程度低于丁卡因组（1小时时为13.3%对40.0%，P = 0.039；2小时和6小时时为33.3%对60%，P = 0.038）。
通过图像演示对尿道插管进行术前教育可增强丁卡因黏液减少CRBD发生率和严重程度的效果。
该试验在www.clinicaltrials.gov注册，注册号为NCT03199105（追溯注册）。试验注册日期为“2017年6月26日”。
