title: Effect of morphine on lower urinary tract discomfort after transurethral resection of prostate under general anesthesia: a randomised clinical study.
abstract: BACKGROUND
  Lower urinary tract (LUT) discomfort is a common complaint after transurethral resection of the prostate (TURP), and it may lead to agitation and restlessnes. We have evaluated the efficacy of morphine for preventing TURP-related LUT discomfort symptoms.
  
  
  METHODS
  This was a prospective randomised study including 60 patients (American Society of Anesthesiologists class I and II) who were scheduled to undergo TURP. The patients were divided into two equally sized groups (group M: morphine, group C: control). A standartized anesthesia method was used. Group M patients received morphine 0.04 mg/kg intravenous (iv) in 100 ml of normal saline followed by an infusion of morphine for 24 h (0.01 mg/kg/h); group C patients received 100 ml normal saline 20 min before the expected extubation time, followed by a normal saline infusion which looked identical to that of the morphine infusion. The incidences and severity of LUT discomfort, postoperative pain, sedation level, postoperative nausea and vomiting (PONV) and respiratory depression were recorded at 0, 1, 2, 6, 12 and 24 h postoperatively.
  
  
  RESULTS
  The incidence of LUT discomfort was lower in group M patients at all time points during the study (p < 0.05) except for 2 h postoperatively, and the severity of LUT discomfort was also lower this group at 0, 12 and 24 h postoperatively (p = 0.001, p = 0.04 and p = 0.02, respectively). Pain (numeric rating scale) scores were lower in group M patients at 0 (p = 0.003) and 6 h (p < 0.001). The need for rescue analgesic was lower in group M patients (19 patients in group C, 10 patients in group M; p = 0.04). The incidence of PONV was higher in group M patients (p = 0.03). The incidence of pruritus, respiratory depression and over-sedation were similar among the groups.
  
  
  CONCLUSIONS
  Based on these results, we conclude that morphine effectively reduces LUT discomfort after TURP at a cost of postoperative nausea and vomiting.
authors.affiliation: Department of Anesthesiology, Yeditepe University Hospital A.D. Kozyatagı, State Highway Ankara Cad. No: 102/104, Kozyatagi, Istanbul, Turkey, fmenda@yeditepe.edu.tr.
authors.forename: Ferdi
authors.initials: F
authors.lastname: Menda
authors.forename: Sibel
authors.initials: S
authors.lastname: Temur
authors.forename: Sevgi
authors.initials: S
authors.lastname: Bilgen
authors.forename: Faruk
authors.initials: F
authors.lastname: Yencilek
authors.forename: Hakan
authors.initials: H
authors.lastname: Koyuncu
authors.forename: Nurcan
authors.initials: N
authors.lastname: Sancar
authors.forename: Ozge
authors.initials: O
authors.lastname: Koner
mesh_terms: D000368:Aged; D000768:Anesthesia, General / Q000379:methods*; D004311:Double-Blind Method; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000188:drug therapy* / Q000517:prevention & control*; D008297:Male; D009020:Morphine / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011446:Prospective Studies; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000379:methods*; D014551:Urinary Tract / Q000601:surgery
chemical_list: D009020:Morphine