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BJA Advance Access originally published online on July 24, 2008
British Journal of Anaesthesia 2008 101(4):506-510; doi:10.1093/bja/aen217
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Evaluation of intra-operative tramadol for prevention of catheter-related bladder discomfort: a prospective, randomized, double-blind study

A. Agarwal1,*, G. Yadav1, D. Gupta1, P. K. Singh1 and U. Singh2

1 Department of Anaesthesiology
2 Department of Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, India

* Corresponding author. E-mail: aagarwal{at}sgpgi.ac.in

Background: Catheter-related bladder discomfort (CRBD) is defined as an urge to void or discomfort in the supra-pubic region; reported postoperatively in patients who have had urinary catheterization intra-operatively. We have evaluated tramadol, a centrally acting opioid analgesic with muscarinic receptor antagonist properties for prevention of CRBD.

Methods: Fifty-four adults (18–60 yr), ASA physical status I and II of either sex, undergoing elective percutaneous nephro-lithomy were randomly divided into two groups of 27 each. Control (C) group received normal saline (NS; 2 ml), whereas Tramadol (T) group received tramadol 1.5 mg kg–1. All medications were diluted in 2 ml NS and administered 30 min before extubation. Intra-operatively, urinary catherization was performed with a 16 Fr Foley's catheter, and the balloon was inflated with 10 ml distilled water. The CRBD was assessed at 0, 1, 2, and 6 h after patient's arrival in the post-anaesthesia care unit along with total postoperative fentanyl requirement. Severity of CRBD was graded as none, mild, moderate and severe. Data were analysed by one-way ANOVA, Z-test, and Fisher's exact test. P<0.05 was considered significant.

Results: Incidence and severity of CRBD was reduced in T group compared with C group at all time points (P<0.05). Postoperative pain as assessed by visual analogue scale and total postoperative fentanyl requirement (µg kg–1) was also reduced in the T group [176 (SD 26.5)] compared with C group [210 (34.6)] (P<0.05).

Conclusions: Tramadol 1.5 mg kg–1 administered i.v. 30 min before extubation decreases the incidence and severity of CRBD and postoperative fentanyl requirement.

Keywords: complications, catheter-related bladder discomfort; pharmacology, tramadol


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