title: The efficacy of tolterodine for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study.
abstract: Bladder discomfort secondary to an indwelling urinary catheter is distressing, particularly for patients awakening from anesthesia. We sought to discover the incidence and severity of bladder discomfort in patients who were catheterized intraoperatively and to evaluate the efficacy of tolterodine, a pure muscarinic receptor antagonist, in preventing this. Two-hundred-fifteen consecutive adult patients, ASA physical status I and II, either sex, undergoing urologic surgery requiring bladder catheterization were enrolled. Group C (control, n = 165) received placebo and group T (tolterodine, n = 50) received tolterodine 2 mg. Drugs were administered orally 1 h before surgery. After induction of anesthesia, patients were catheterized with a 16F Foley catheter and the balloon was inflated with 10 mL of normal saline. In the postanesthesia care unit, bladder discomfort was assessed on arrival (0), 1, 2 and 6 h. Severity of bladder discomfort was graded as mild, moderate, and severe. Bladder discomfort observed in group C was 55% (91 of 165). Tolterodine reduced both the incidence 36% (18 of 50) and severity of bladder discomfort (P < 0.05).
  
  
  CONCLUSIONS
  Bladder discomfort secondary to an indwelling urinary catheter is distressing to patients. In the present study, we observed that tolterodine (2 mg), a competitive muscarinic receptor antagonist administered 1 h before surgery, reduced both the incidence and severity of bladder discomfort secondary to bladder catheterization.
authors.affiliation: Departments of *Anesthesia, †Surgical Urology, and ‡Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Agarwal
authors.forename: Mehdi
authors.initials: M
authors.lastname: Raza
authors.forename: Vinay
authors.initials: V
authors.lastname: Singhal
authors.forename: Sanjay
authors.initials: S
authors.lastname: Dhiraaj
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kapoor
authors.forename: Aneesh
authors.initials: A
authors.lastname: Srivastava
authors.forename: Devendra
authors.initials: D
authors.lastname: Gupta
authors.forename: Prabhat K
authors.initials: PK
authors.lastname: Singh
authors.forename: Chandra Kant
authors.initials: CK
authors.lastname: Pandey
authors.forename: Uttam
authors.initials: U
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D001559:Benzhydryl Compounds / Q000627:therapeutic use*; D003408:Cresols / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D010665:Phenylpropanolamine / Q000627:therapeutic use*; D011446:Prospective Studies; D000068737:Tolterodine Tartrate; D001745:Urinary Bladder Diseases / Q000517:prevention & control*; D014546:Urinary Catheterization / Q000009:adverse effects*
chemical_list: D001559:Benzhydryl Compounds; D003408:Cresols; D018727:Muscarinic Antagonists; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate