title: Evaluation of efficacy of amikacin for attenuation of catheter-related bladder discomfort in patients undergoing percutaneous nephrolithotomy: A prospective, randomized, placebo-controlled, double-blind study.
abstract: BACKGROUND
  Catheter-related bladder discomfort (CRBD) is the most distressing symptom in patients due to intraoperative urinary catheterization. Amikacin significantly inhibits detrusor contraction evoked by prejunctional stimulation.
  
  
  OBJECTIVE
  The aim of this study is to evaluate the efficacy of amikacin in prevention of CRBD in patients undergoing percutaneous nephrolithotomy.
  
  
  METHODS
  Study areas were operation theater and postanesthesia care unit of the Department of Anesthesiology, SGPGIMS, Lucknow.
  
  
  METHODS
  One hundred adult patients of either sex were randomly assigned into two groups of fifty each. Patients in control group received normal saline whereas patients in amikacin group received amikacin 10 mg/kg just before induction. Grading of CRBD was done as none, mild, moderate, and severe by a blinded observer at 0, 1, 6, 12, and 24 h after surgery.
  
  
  METHODS
  Data were analyzed using Student'st-test and Chi-square test among groups. Incidence of CRBD was compared with Chi-square test whereas severity was analyzed by the test of proportions (Z-test). Visual analog score was compared using Mann-Whitney U-test for surgical site pain.
  
  
  RESULTS
  Incidence of CRBD in control group was 66% as compared to 44% observed in amikacin group (P< 0.05). During intergroup comparison at different time points, incidence of CRBD was reduced at 1 and 6 h in the amikacin group (P< 0.05). Significant reduction in the severity of CRBD (moderate) was also observed at 1 h in the amikacin group (P< 0.05). At rest of the time points, there was no significant difference.
  
  
  CONCLUSIONS
  Amikacin can significantly reduce the incidence and severity of CRBD in the first few hours after surgery.
authors.affiliation: Department of Anesthesiology, T S Mishra Medical College and Hospital, Amausi, Lucknow, Uttar Pradesh, India.
authors.forename: Ruchi
authors.initials: R
authors.lastname: Verma
authors.affiliation: Department of Anesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Agarwal
authors.affiliation: Department of Anesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Prabhat Kumar
authors.initials: PK
authors.lastname: Singh
authors.affiliation: Department of Anesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Devendra
authors.initials: D
authors.lastname: Gupta
authors.affiliation: Department of Anesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: Rafat
authors.initials: R
authors.lastname: Shamim
keywords: Amikacin; catheter-related bladder discomfort; percutaneous nephrolithotomy