Department of Urology, Guizhou Province People's Hospital, Guiyang, China.
Evidence-Based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
BMC Urol. 2023 Mar 3;23(1):29. doi: 10.1186/s12894-023-01195-9.
Catheter-related bladder discomfort (CRBD) is a common postoperative bladder pain syndrome. Many drugs and interventions for managing CRBD have been studied, but their comparative effectiveness remains controversial. We made a study to assess the comparative effectiveness of interventions included Ketorolac, Lidocaine, Chlorpheniramine, Gabapentin, Magnesium, Nefopam, Oxycodone, Parecoxib, Solifenacin, Tolterodine, Bupivancaine, Dexmedetomidine, Hyoscine N-butyl bromide, Ketamine, Penile nerve block on urological postoperative CRBD.
We performed a network meta-analysis via Aggregate Data Drug Inormation System software included 18 studies with 1816 patients and assessed the risk of bias by Cochrane Collaboration tool. The incidence of moderate to severe CRBD at 0, 1, and 6 h after surgery and the incidence severe CRBD at 1 h after surgery were compared.
The number of best rank is 0.48(Nefopam) and 0.22(Nefopam) in the incidence of moderate to severe CRBD at 1 h and incidence severe CRBD at 1 h. More than half of studies at unclear or high risk of bias.
Nefopam reduced the incidence of CRBD and prevented severe events, but limited by the small number of studies for each intervention and heterogeneous patients.
导管相关性膀胱不适（CRBD）是一种常见的术后膀胱疼痛综合征。已经研究了许多用于管理 CRBD 的药物和干预措施，但它们的相对有效性仍存在争议。我们进行了一项研究，以评估包括酮咯酸、利多卡因、氯苯那敏、加巴喷丁、镁、奈福泮、羟考酮、帕瑞昔布、索利那新、托特罗定、布比卡因、右美托咪定、氢溴酸东莨菪碱、氯胺酮、阴茎神经阻滞在内的干预措施对泌尿科术后 CRBD 的相对有效性。
我们通过 Aggregate Data Drug Inormation System 软件进行了一项网络荟萃分析，该软件包含 18 项研究和 1816 名患者，并通过 Cochrane 协作工具评估了偏倚风险。比较了手术后 0、1 和 6 小时中度至重度 CRBD 的发生率以及手术后 1 小时重度 CRBD 的发生率。
在 1 小时中度至重度 CRBD 发生率和 1 小时重度 CRBD 发生率方面，最佳排名的数字分别为 0.48（奈福泮）和 0.22（奈福泮）。超过一半的研究存在不明确或高偏倚风险。
奈福泮降低了 CRBD 的发生率并预防了严重事件，但受限于每个干预措施的研究数量较少和患者异质性。
