Lee Sangmin, Kim Kwang Taek, Kim Tae Beom, Chung Kyung Jin, Huh Kookjin, Kim Hwanik, Song Sang Hoon
Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea.
Department of Urology, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon 21565, Republic of Korea.
J Clin Med. 2025 Jun 13;14(12):4215. doi: 10.3390/jcm14124215.
Catheter-related bladder discomfort (CRBD) commonly occurs in patients undergoing urologic surgery and significantly affects patient comfort and recovery. We evaluated the efficacy and safety of continuous local ropivacaine infusion using a specialized multi-porous urethral catheter in reducing postoperative CRBD. : This multicenter, prospective, randomized, single-blind trial enrolled 136 male patients undergoing short-term catheterization after urologic surgery. Participants were randomized into three groups-a control group receiving saline infusion, Group 1 receiving 0.5% ropivacaine at 1 mL/h, and Group 2 receiving 0.5% ropivacaine at 2 mL/h-for up to 48 h via a multi-porous urethral catheter. The primary outcome was the incidence of CRBD at 24 h postoperatively. Secondary outcomes included changes in urethral pain assessed by a visual analog scale (VAS), urinary symptom scores, complication rates, and patient-reported catheter inconvenience and reuse intention using Likert scales. : The incidence of CRBD was significantly lower in Group 1 (19.6%) and Group 2 (11.1%) compared to the control group (44.4%; = 0.001), demonstrating a clear dose-response relationship. Changes in urethral pain scores (VAS) from baseline were significantly lower in the ropivacaine groups compared to the control ( = 0.023). Complication rates were similar among groups (control 13.3%, Group 1 6.5%, Group 2 15.6%; = 0.378), although catheter leakage occurred more frequently in Group 2, without statistical significance ( = 0.122). : Continuous local ropivacaine infusion using a multi-porous urethral catheter effectively reduces the incidence of postoperative CRBD without increasing side effects. This approach may improve patient comfort during perioperative catheter management.
导尿管相关膀胱不适(CRBD)常见于接受泌尿外科手术的患者中,并且显著影响患者的舒适度和恢复情况。我们评估了使用专门的多孔尿道导管持续局部输注罗哌卡因在降低术后CRBD方面的疗效和安全性。:这项多中心、前瞻性、随机、单盲试验纳入了136例泌尿外科手术后接受短期导尿的男性患者。参与者被随机分为三组——对照组接受生理盐水输注,第1组以1 mL/h的速度接受0.5%罗哌卡因输注,第2组以2 mL/h的速度接受0.5%罗哌卡因输注——通过多孔尿道导管持续输注长达48小时。主要结局是术后24小时CRBD的发生率。次要结局包括通过视觉模拟量表(VAS)评估的尿道疼痛变化、泌尿系统症状评分、并发症发生率,以及患者使用李克特量表报告的导尿管不便情况和再次使用意愿。:与对照组(44.4%;P = 0.001)相比,第1组(19.6%)和第2组(11.1%)的CRBD发生率显著更低,显示出明确的剂量反应关系。与对照组相比,罗哌卡因组尿道疼痛评分(VAS)较基线的变化显著更低(P = 0.023)。各组间并发症发生率相似(对照组13.3%,第1组6.5%,第2组15.6%;P = 0.378),尽管第2组导尿管漏液发生得更频繁,但无统计学意义(P = 0.122)。:使用多孔尿道导管持续局部输注罗哌卡因可有效降低术后CRBD的发生率,且不增加副作用。这种方法可能会改善围手术期导尿管管理期间的患者舒适度。