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Effects of an intraoperative intravenous Bolus Dose of Dexmedetomidine on postoperative catheter-related bladder discomfort in male patients undergoing transurethral resection of bladder tumors: a randomized, double-blind, controlled trial

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Abstract

Purpose

To investigate whether the effect of intravenous bolus doses of dexmedetomidine on postoperative catheter-related bladder discomfort (CRBD) was dose-dependent in male patients undergoing transurethral resection of bladder tumors (TURBT).

Methods

The study protocol was registered at the Chinese Clinical Trial Registry (ChiCTR 2,000,034,657, date of registration: July 14, 2020). Adult male patients were randomized to one of four groups: placebo (Group C); dexmedetomidine 0.2 µg/kg (Group D 0.2); dexmedetomidine 0.5 µg/kg (Group D 0.5); or dexmedetomidine 1 µg/kg (Group D 1). The primary outcome was the incidence of moderate-to-severe CRBD at 0, 1, 6, 24, and 48 h postoperatively.

Results

The incidence of moderate-to-severe CRBD was significantly lower in Group D 0.5 and Group D 1 than in Group C at 0 h (13% vs. 40%, P = 0.006; 8% vs. 40%, P = 0.001), 1 h (15% vs. 53%, P < 0.001; 13% vs. 53%, P < 0.001), and 6 h (10% vs. 32%, P = 0.025; 8% vs. 32%, P = 0.009) postoperatively. Compared with baseline, both the MAP and HR were significantly lower in Group D 1 at 1 min ([94 ± 15] vs. [104 ± 13] mm Hg, P = 0.003; [64 ± 13] vs. [73 ± 13] bpm, P = 0.001) and 30 min ([93 ± 10] vs. [104 ± 13] mm Hg, P < 0.001; [58 ± 9] vs. [73 ± 13] bpm, P < 0.001) postextubation.

Conclusion

The effect of intravenous bolus doses of dexmedetomidine on postoperative CRBD was dose-independent, whereas intravenous administration of 0.5 µg/kg dexmedetomidine reduced the early postoperative incidence of CRBD with minimal side effects.

Trial registration

Clinical trial number and registry URL: ChiCTR 2,000,034,657, http://www.chictr.org.cn, date of registration: July 14, 2020.

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Data availability

The data and materials are available from the corresponding author on reasonable request.

References

  1. Bai Y, Wang X, Li X, Pu C, Yuan H, Tang Y et al (2015) Management of catheter-related bladder discomfort in patients who underwent elective surgery. J Endourol 29(6):640–649

    Article  PubMed  PubMed Central  Google Scholar 

  2. Binhas M, Motamed C, Hawajri N, Yiou R, Marty J (2011) Predictors of catheter-related bladder discomfort in the post-anaesthesia care unit. Ann Fr Anesth Reanim 30(2):122–125

    Article  CAS  PubMed  Google Scholar 

  3. Shariat Moharari R, Lajevardi M, Khajavi M, Najafi A, Shariat Moharari G, Etezadi F (2014) Effects of intra-operative ketamine administration on postoperative catheter-related bladder discomfort: a double-blind clinical trial. Pain Pract 14(2):146–150

    Article  PubMed  Google Scholar 

  4. Agarwal A, Yadav G, Gupta D, Singh PK, Singh U (2008) Evaluation of intra-operative tramadol for prevention of catheter-related bladder discomfort: a prospective, randomized, double-blind study. Br J Anaesth 101(4):506–510

    Article  CAS  PubMed  Google Scholar 

  5. Nam K, Seo JH, Ryu JH, Oh AY, Lee T, Park HP et al (2015) Randomized, clinical trial on the preventive effects of butylscopolamine on early postoperative catheter-related bladder discomfort. Surgery 157(2):396–401

    Article  PubMed  Google Scholar 

  6. Huh H, Lee SW, Cho JE, Kim HC (2021) Effect of chlorpheniramine administration on postoperative catheter-related bladder discomfort in patients undergoing transurethral excision of bladder tumor: a prospective randomized study. J Anesth

  7. Khan ZP, Ferguson CN, Jones RM (1999) alpha-2 and imidazoline receptor agonists. Their pharmacology and therapeutic role. Anaesthesia 54(2):146–165

    Article  CAS  PubMed  Google Scholar 

  8. Mantz J, Josserand J, Hamada S (2011) Dexmedetomidine: new insights. Eur J Anaesthesiol 28(1):3–6

    Article  CAS  PubMed  Google Scholar 

  9. Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD (2000) The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology 93(2):382–394

    Article  CAS  PubMed  Google Scholar 

  10. Takizuka A, Minami K, Uezono Y, Horishita T, Yokoyama T, Shiraishi M et al (2007) Dexmedetomidine inhibits muscarinic type 3 receptors expressed in Xenopus oocytes and muscarine-induced intracellular Ca2 + elevation in cultured rat dorsal root ganglia cells. Naunyn Schmiedebergs Arch Pharmacol 375(5):293–301

    Article  CAS  PubMed  Google Scholar 

  11. Kim HC, Lee YH, Jeon YT, Hwang JW, Lim YJ, Park JE et al (2015) The effect of intraoperative dexmedetomidine on postoperative catheter-related bladder discomfort in patients undergoing transurethral bladder tumour resection: a double-blind randomised study. Eur J Anaesthesiol 32(9):596–601

    Article  CAS  PubMed  Google Scholar 

  12. Kwon Y, Jang JS, Hwang SM, Lee JJ, Tark H (2018) Intraoperative administration of dexmedetomidine reduced the postoperative catheter-related bladder discomfort and pain in patients undergoing lumbar microdiscectomy. J Anesth 32(1):41–47

    Article  PubMed  Google Scholar 

  13. Li SY, Li H, Ni J, Ma YS (2019) Comparison of intravenous lidocaine and dexmedetomidine infusion for prevention of postoperative catheter-related bladder discomfort: a randomized controlled trial. BMC Anesthesiol 19(1):37

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Lee C, Kim YD, Kim JN (2013) Antihyperalgesic effects of dexmedetomidine on high-dose remifentanil-induced hyperalgesia. Korean J Anesthesiol 64(4):301–307

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Yu Z, Wu W, Wu X, Lei H, Gong C, Xu S (2016) Protective effects of dexmedetomidine combined with flurbiprofen axetil on remifentanil-induced hyperalgesia: a randomized controlled trial. Exp Ther Med 12(4):2622–2628

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Agarwal A, Gupta D, Kumar M, Dhiraaj S, Tandon M, Singh PK (2006) Ketamine for treatment of catheter related bladder discomfort: a prospective, randomized, placebo controlled and double blind study. Br J Anaesth 96(5):587–589

    Article  CAS  PubMed  Google Scholar 

  17. Kim HC, Park HP, Lee J, Jeong MH, Lee KH (2017) Sevoflurane vs. propofol in post-operative catheter-related bladder discomfort: a prospective randomized study. Acta Anaesthesiol Scand 61(7):773–780

    Article  CAS  PubMed  Google Scholar 

  18. Li S, Song L, Ma Y, Lin X (2018) Tramadol for the treatment of catheter-related bladder discomfort: a randomized controlled trial. BMC Anesthesiol 18(1):194

    Article  PubMed  PubMed Central  Google Scholar 

  19. Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK et al (2008) Assessment of pain. Br J Anaesth 101(1):17–24

    Article  CAS  PubMed  Google Scholar 

  20. Kamper SJ, Ostelo RW, Knol DL, Maher CG, de Vet HC, Hancock MJ (2010) Global perceived effect scales provided reliable assessments of health transition in people with musculoskeletal disorders, but ratings are strongly influenced by current status. J Clin Epidemiol 63(7):760–766e1

    Article  PubMed  Google Scholar 

  21. Terada S, Irikoma S, Yamashita A, Murakoshi T (2019) Incidence of respiratory depression after epidural administration of morphine for cesarean delivery: findings using a continuous respiratory rate monitoring system. Int J Obstet Anesth 38:32–36

    Article  CAS  PubMed  Google Scholar 

  22. Kim DH, Park JY, Yu J, Lee SA, Park S, Hwang JH et al (2020) Intravenous lidocaine for the Prevention of postoperative catheter-related bladder discomfort in male patients undergoing transurethral resection of bladder tumors: a Randomized, Double-Blind, controlled trial. Anesth Analg 131(1):220–227

    Article  PubMed  Google Scholar 

  23. Park JY, Hong JH, Kim DH, Yu J, Hwang JH, Kim YK (2020) Magnesium and bladder discomfort after transurethral resection of bladder tumor: a Randomized, Double-blind, placebo-controlled study. Anesthesiology 133(1):64–77

    Article  CAS  PubMed  Google Scholar 

  24. Zhang Z, Cao Z, Xu C, Wang H, Zhang C, Pan A et al (2014) Solifenacin is able to improve the irritative symptoms after transurethral resection of bladder tumors. Urology 84(1):117–121

    Article  PubMed  Google Scholar 

  25. Chung JM, Ha HK, Kim DH, Joo J, Kim S, Sohn DW et al (2017) Evaluation of the efficacy of Solifenacin for preventing catheter-related bladder discomfort after transurethral resection of bladder tumors in patients with non-muscle invasive bladder Cancer: a prospective, randomized, Multicenter Study. Clin Genitourin Cancer 15(1):157–162

    Article  PubMed  Google Scholar 

  26. Bloor BC, Ward DS, Belleville JP, Maze M (1992) Effects of intravenous dexmedetomidine in humans. II. Hemodynamic changes. Anesthesiology 77(6):1134–1142

    Article  CAS  PubMed  Google Scholar 

  27. Aouad MT, Zeeni C, Al Nawwar R, Siddik-Sayyid SM, Barakat HB, Elias S et al (2019) Dexmedetomidine for Improved Quality of Emergence from General Anesthesia: a dose-finding study. Anesth Analg 129(6):1504–1511

    Article  PubMed  Google Scholar 

  28. Wu Z, Yu J, Lin Q, Li H, Zhang T, Tan H et al (2021) Effects of an intraoperative intravenous Bolus Dose of Dexmedetomidine on Remifentanil-Induced Postinfusion Hyperalgesia in patients undergoing thyroidectomy: a double-blind randomized controlled trial. Anesth Analg 132(2):320–328

    Article  CAS  PubMed  Google Scholar 

  29. Bicer C, Esmaoglu A, Akin A, Boyaci A (2006) Dexmedetomidine and meperidine prevent postanaesthetic shivering. Eur J Anaesthesiol 23(2):149–153

    Article  CAS  PubMed  Google Scholar 

  30. De Cassai A, Boscolo A, Geraldini F, Zarantonello F, Pettenuzzo T, Pasin L et al (2021) Effect of dexmedetomidine on hemodynamic responses to tracheal intubation: a meta-analysis with meta-regression and trial sequential analysis. J Clin Anesth 72:110287

    Article  PubMed  Google Scholar 

  31. Ma H, Wachtendorf LJ, Santer P, Schaefer MS, Friedrich S, Nabel S et al (2021) The effect of intraoperative dexmedetomidine administration on length of stay in the post-anesthesia care unit in ambulatory surgery: a hospital registry study. J Clin Anesth 72:110284

    Article  CAS  PubMed  Google Scholar 

  32. Jaakola ML, Salonen M, Lehtinen R, Scheinin H (1991) The analgesic action of dexmedetomidine–a novel alpha 2-adrenoceptor agonist–in healthy volunteers. Pain 46(3):281–285

    Article  CAS  PubMed  Google Scholar 

  33. Kauppila T, Kemppainen P, Tanila H, Pertovaara A (1991) Effect of systemic medetomidine, an alpha 2 adrenoceptor agonist, on experimental pain in humans. Anesthesiology 74(1):3–8

    Article  CAS  PubMed  Google Scholar 

  34. Eisenach JC, De Kock M, Klimscha W (1996) Alpha(2)-adrenergic agonists for regional anesthesia. A clinical review of clonidine (1984–1995). Anesthesiology 85(3):655–674

    Article  CAS  PubMed  Google Scholar 

  35. Angst MS, Ramaswamy B, Davies MF, Maze M (2004) Comparative analgesic and mental effects of increasing plasma concentrations of dexmedetomidine and alfentanil in humans. Anesthesiology 101(3):744–752

    Article  CAS  PubMed  Google Scholar 

  36. Seo KH, Kim YI, Kim YS (2014) Optimal dose of dexmedetomidine for attenuating cardiovascular response during emergence in patients undergoing total laparoscopic hysterectomy. J Int Med Res 42(5):1139–1149

    Article  CAS  PubMed  Google Scholar 

  37. Kim HC, Lim SM, Seo H, Park HP (2015) Effect of glycopyrrolate versus atropine coadministered with neostigmine for reversal of rocuronium on postoperative catheter-related bladder discomfort in patients undergoing transurethral resection of bladder tumor: a prospective randomized study. J Anesth 29(6):831–835

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China

    Tianhua Zhang, Huiting Li, Chunnan Lin, Rui An, Wenqian Lin, Hongying Tan & Longhui Cao

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  1. Tianhua Zhang
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  2. Huiting Li
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  3. Chunnan Lin
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Contributions

Tianhua Zhang: This author helped data curation, formal analysis, investigation, project administration and roles/writing - original draft. Huiting Li: This author helped data curation, investigation and project administration. Lan Xie: This author helped data curation.Rui An: This author helped data curation and investigation. Wenqian Lin: This author helped project administration and resources. Hongying Tan: This author helped project administration and visualization. Longhui Cao: This author helped conceptualization, project administration, methodology, supervision, validation and writing - review & editing. All authors reviewed the manuscript.

Corresponding authors

Correspondence to Hongying Tan or Longhui Cao.

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Ethical approval

This prospective, randomized, double-blind, placebo-controlled study was performed with the approval of the Ethical Committee of the Sun Yat-sen University Cancer Centre, Guangzhou, China (B2020-385-01).

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was obtained from all individual participants included in the study.

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The authors affirm that human research participants provided informed consent for publication of the images in Figure(s) 1, 2 and 3.

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Zhang, T., Li, H., Lin, C. et al. Effects of an intraoperative intravenous Bolus Dose of Dexmedetomidine on postoperative catheter-related bladder discomfort in male patients undergoing transurethral resection of bladder tumors: a randomized, double-blind, controlled trial. Eur J Clin Pharmacol 80, 465–474 (2024). https://doi.org/10.1007/s00228-024-03625-5

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