Article Data

  • Views 1618
  • Dowloads 174

Original Research

Open Access

A COMPARISON OF THE EFFECTS OF GENERAL ANESTHESIA VERSUS SPINAL ANESTHESIA ON CATHETER-RELATED BLADDER DISCOMFORT AFTER HoLEP: A PROSPECTIVE TRIAL

  • A Ram Doo1,2
  • Yu Seob Shin2,3
  • Juhan Mun1,2
  • Deokkyu Kim1,2
  • Jong Kwan Park2,3

1Department of Anesthesiology and Pain Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea

2Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea

3Department of Urology, Jeonbuk National University Medical School, Jeonju, Republic of Korea

DOI: 10.15586/jomh.v16iSP1.227 Vol.16,Issue SP1,April 2020 pp.25-34

Published: 01 April 2020

*Corresponding Author(s): Yu Seob Shin E-mail: ball1210@hanmail.net

Abstract

Background and objective

Using an indwelling urinary catheter during lower urinary tract surgeries frequently leads to cathe-ter-related bladder discomfort (CRBD) in the immediate postoperative period. The purpose of the present study was to compare the effectiveness of general and spinal anesthesia on CRBD in patients who underwent Holmium laser enucleation of the prostate (HoLEP).

Material and methods

This clinical trial included male patients who underwent HoLEP for benign prostatic hyperplasia. Forty-five participants were divided into two groups: general anesthesia and spinal anesthesia. The incidence and the severity of CRBD were assessed postoperatively for 24 h. The severity of CRBD was graded using an 11-point scale (0 = no CRBD, 10 = worst CRBD imaginable). Moderate to severe CRBD, having a score of ≥4, was treated with 1 μg/kg fentanyl incrementally every 5 min during imme-diate postoperative period, and the total consumption was compared between the two groups.

Results

The overall incidence of CRBD 24 h following HoLEP was 80% in the general anesthesia group, which was significantly higher than that of the spinal anesthesia group (p = 0.017). The severity of CRBD was significantly lower in the spinal anesthesia group compared with the general anesthesia group postoper-atively at 2 and 6 h (p < 0.001 and p = 0.005 respectively). Furthermore, opioid consumption was signifi-cantly higher in the general anesthesia group compared with the spinal anesthesia group (p = 0.009).

Conclusion

Spinal anesthesia has a CRBD-reductive effect compared with general anesthesia during the early postoperative hours following HoLEP.

Keywords

benign prostatic hyperplasia; recovery; urinary catheter

Cite and Share

A Ram Doo,Yu Seob Shin,Juhan Mun,Deokkyu Kim,Jong Kwan Park. A COMPARISON OF THE EFFECTS OF GENERAL ANESTHESIA VERSUS SPINAL ANESTHESIA ON CATHETER-RELATED BLADDER DISCOMFORT AFTER HoLEP: A PROSPECTIVE TRIAL. Journal of Men's Health. 2020. 16(SP1);25-34.

References

1. Eredics K, Wachabauer D, Rothlin F, Madersbacher S, Schauer I. Reoperation rates and mortality after transurethral and open prostatectomy in a long-term nationwide analysis: Have we improved over a decade? Urology 2018;118:152–7. https://doi. org/10.1016/j.urology.2018.04.032

2. Shin YS, Park JK. Changes in surgical strategy for patients with benign prostatic hyperplasia: 12-year single-center experience. Korean J Urol 2011;52: 189–93. https://doi.org/10.4111/kju.2011.52.3.189

3. Kim M, Shin YS. It’s time to take advantage of robotic-assisted simple prostatectomy in large benign prostatic hyperplasia. World J Mens Health 2019;37:374–5. https://doi.org/10.5534/wjmh.180106

4. Xiaoqiang L, Xuerong Z, Juan L, et al. Efficacy of pudendal nerve block for alleviation of catheter-re-lated bladder discomfort in male patients undergo-ing lower urinary tract surgeries: A randomized, controlled, double-blind trial. Medicine (Baltimore) 2017;96:e8932. https://doi.org/10.1097/MD.000000 0000008932

5. Kim HC, Hong WP, Lim YJ, Park HP. The effect of sevoflurane versus desflurane on postoperative catheter-related bladder discomfort in patients undergoing transurethral excision of a bladder tumour: A randomized controlled trial. Can J Anaesth 2016;63:596–602. https://doi.org/10. 1007/s12630-016-0600-7

6. Aono J, Ueda W, Mamiya K, Takimoto E, Manabe M. Greater incidence of delirium during recovery from sevoflurane anesthesia in preschool boys. Anesthesiology 1997;87:1298–300. https://doi.org/10.1097/00000542-199712000-00006

7. Lee JH, Kim D, Seo D, Son JS, Kim DC. Validity and reliability of the korean version of the quality of recovery-40 questionnaire. Korean J Anesthesiol 2018;71:467–75. https://doi.org/10.4097/kja.d.18. 27188

8. Hu B, Li C, Pan M, et al. Strategies for the pre-vention of catheter-related bladder discomfort: A prisma-compliant systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2016;95:e4859. https://doi. org/10.1097/MD.0000000000004859

9. Fields A, Huang J, Schroeder D, Sprung J, Weingarten T. Agitation in adults in the post-an-aesthesia care unit after general anaesthesia. Br J Anaesth 2018;121:1052–8. https://doi.org/10. 1016/ j.bja.2018.07.017

 10. Lepouse C, Lautner CA, Liu L, Gomis P, Leon A. Emergence delirium in adults in the post-anaesthe-sia care unit. Br J Anaesth 2006;96:747–53. https://doi.org/10.1093/bja/ael094

 11. Smith LM, Cozowicz C, Uda Y, et al. Neuraxial and combined neuraxial/general anesthesia compared to general anesthesia for major trun-cal and lower limb surgery: A systematic review and meta-analysis. Anesth Analg 2017;125: 1931–45. https://doi.org/10.1213/ANE.0000000 000002069

 12. Curatolo M. Regional anesthesia in pain manage-ment. Curr Opin Anaesthesiol 2016;29:614–19. https://doi.org/10.1097/ACO.0000000000000353

 13. Mason SE, Noel-Storr A, Ritchie CW. The impact of general and regional anesthesia on the incidence of post-operative cognitive dysfunction and post-op-erative delirium: A systematic review with meta-anal-ysis. J Alzheimers Dis 2010;22(Suppl 3):67–79. https://doi.org/10.3233/JAD-2010-101086

 14. Guay J, Choi PT, Suresh S, Albert N, Kopp S, Pace NL. Neuraxial anesthesia for the prevention of postoperative mortality and major morbidity: An overview of cochrane systematic reviews. Anesth Analg 2014;119:716–25. https://doi. org/10.1213/ANE.0000000000000339

 15. Carlock KD, Hildebrandt KR, Konda SR, Egol KA. The use of regional anaesthesia for surgical intervention has minimal effect on functional out-comes following fracture nonunion repair. Injury 2019;50:671–5.

 16. Broos PP, Stokmans RA, Cuypers PW, Egol KA. Effects of anesthesia type on perioperative out-come after endovascular aneurysm repair. J Endovasc Ther 2015;22:770–7. https://doi. org/10.1016/j.injury.2019.01.013

 17. Shin YS, Doo AR. Managing postoperative cathe-ter-related bladder discomfort. J Anesth 2019;33:347. https://doi.org/10.1007/s00540-019-02619-3

 18. Shin YS, Doo AR. Park HJ. The novel method to reduce catheter-related bladder discomfort after transurethral prostate surgery. World J Mens Health 2020;38:137–8. https://doi.org/10.5534/wjmh.190069

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Directory of Open Access Journals (DOAJ) DOAJ is a unique and extensive index of diverse open access journals from around the world, driven by a growing community, committed to ensuring quality content is freely available online for everyone.

SCImago The SCImago Journal & Country Rank is a publicly available portal that includes the journals and country scientific indicators developed from the information contained in the Scopus® database (Elsevier B.V.)

Publication Forum - JUFO (Federation of Finnish Learned Societies) Publication Forum is a classification of publication channels created by the Finnish scientific community to support the quality assessment of academic research.

Scopus: CiteScore 0.7 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Norwegian Register for Scientific Journals, Series and Publishers Search for publication channels (journals, series and publishers) in the Norwegian Register for Scientific Journals, Series and Publishers to see if they are considered as scientific. (https://kanalregister.hkdir.no/publiseringskanaler/Forside).

Submission Turnaround Time

Conferences

Top