title: The effect of intraoperative dexmedetomidine on postoperative catheter-related bladder discomfort in patients undergoing transurethral bladder tumour resection: A double-blind randomised study.
abstract: BACKGROUND
  Catheter-related bladder discomfort (CRBD) due to an indwelling urinary catheter causes postoperative distress. Dexmedetomidine is used as an anaesthetic adjuvant during general anaesthesia and has an antimuscarinic effect, which may be beneficial for the prevention and treatment of CRBD.
  
  
  OBJECTIVE
  To determine the effect of intraoperative dexmedetomidine administration on the incidence of CRBD.
  
  
  METHODS
  A double-blind, placebo-controlled, randomised study.
  
  
  METHODS
  A tertiary care teaching hospital.
  
  
  METHODS
  One-hundred and nine patients undergoing transurethral bladder tumour excision (TURB).
  
  
  METHODS
  Patients were randomly allocated to two groups: control group (n = 55) received placebo and dexmedetomidine group (n = 54) received intraoperative dexmedetomidine (1 μg kg(-1) loading dose followed by 0.5 μg kg(-1) h(-1) continuous infusion).
  
  
  METHODS
  The incidence and severity (mild, moderate, severe) of CRBD assessed at 0, 1, 6 and 24 h postoperatively.
  
  
  RESULTS
  The incidence of CRBD was significantly higher in the control group at 0 (78 vs. 50%; P = 0.004), 1 (86 vs. 57%; P = 0.002) and 6 h (82 vs. 63%; P = 0.047) postoperatively. The incidence of moderate to severe CRBD was higher in the control group at 0 (38 vs. 11%; P = 0.002) and 1 h (29 vs. 7%; P = 0.006) postoperatively. The number of patients having CRBD treated with tramadol was higher in the control group (24 vs. 12; P = 0.006). The mean end-tidal desflurane concentration during the surgery was higher in the control group (4.5 vs. 3.9%; P = 0.04). The postoperative pain score (numerical rating scale: 0 to 10) was higher in the control group at 0 (4.6 vs. 2.7; P = 0.002), and 1 h (3.8 vs. 2.7; P = 0.041). The number of patients treated with opioids was higher in the control group (21 vs. 8; P = 0.011).
  
  
  CONCLUSIONS
  Intraoperative dexmedetomidine administration decreased the incidence and severity of early postoperative CRBD as well as intraoperative desflurane and postoperative opioid requirements in patients undergoing TURB.
  NCT01991223 (www.clinicaltrials.gov).
authors.affiliation: From the Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (HCK, YHL, YJL, JEP, HPP), and Department of Anaesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea (YTJ, JWH).
authors.forename: Hyun-Chang
authors.initials: HC
authors.lastname: Kim
authors.forename: Yong-Hun
authors.initials: YH
authors.lastname: Lee
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Jeon
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Hwang
authors.forename: Young-Jin
authors.initials: YJ
authors.lastname: Lim
authors.forename: Jung-Eun
authors.initials: JE
authors.lastname: Park
authors.forename: Hee-Pyoung
authors.initials: HP
authors.lastname: Park
mesh_terms: D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000187:drug effects / Q000379:methods; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000601:surgery*; D062885:Urinary Catheters / Q000009:adverse effects*
chemical_list: D018712:Analgesics, Non-Narcotic; D020927:Dexmedetomidine