Document Detail


Sublingual oxybutynin reduces postoperative pain related to indwelling bladder catheter after radical retropubic prostatectomy.
MedLine Citation:
PMID:  17681969     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Bladder discomfort related to an indwelling catheter can exacerbate postoperative pain. It mimics overactive bladder syndrome that is resistant to conventional opioid therapy. Muscarinic receptor antagonists are effective for treatment of the overactive bladder. The aim of this study was to assess the efficacy of oxybutynin in the management of postoperative pain after radical prostatectomy. METHOD: Forty-six ASA I or II men undergoing radical retropubic prostatectomy under general anaesthesia were randomly assigned to two groups, in a double-blind fashion: Group O and Group P (n = 23 each). Group O and Group P received, respectively, sublingual oxybutynin 5 mg or placebo every 8 h during the 24 h after surgery. A 16F Foley catheter was placed during the vesico-urethral anastomosis and the balloon inflated with 10 ml of saline. Pain was assessed in the recovery room starting 10 min after extubation using a 100-point visual analogue scale (VAS). The patients were asked to specify whether pain was related to the surgical incision or bladder pain. Standardized postoperative analgesia included acetaminophen and tramadol administered via a patient-controlled analgesia system. RESULTS: The incidence of bladder catheter pain was 65% (15 of 23 patients) in Group P compared with 17% (4 of 23 patients) in Group O (P < 0.01). Overall VAS scores at rest were significantly lower in Group O. Cumulative tramadol consumption was 322.9(124.3) mg [mean(sd)] in Group P and 146(48) mg in Group O (P < 0.01). No oxybutynin-related side-effects were reported. CONCLUSIONS: Sublingual oxybutynin is an effective treatment for postoperative pain after radical retropubic prostatectomy and produces a significant reduction in tramadol requirements.
Authors:
P Tauzin-Fin; M Sesay; L Svartz; M-C Krol-Houdek; P Maurette
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2007-08-06
Journal Detail:
Title:  British journal of anaesthesia     Volume:  99     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-10     Completed Date:  2007-11-13     Revised Date:  2008-05-13    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  572-5     Citation Subset:  IM    
Affiliation:
DAR III, Hôpital Pellegrin-Tondu Bordeaux, Place Amélie Raba-Léon, 33076 Bordeaux cedex, France. patrick.tauzin-fin@chu-bordeaux.fr
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MeSH Terms
Descriptor/Qualifier:
Administration, Sublingual
Aged
Analgesia, Patient-Controlled
Analgesics, Opioid / administration & dosage
Catheters, Indwelling / adverse effects
Double-Blind Method
Drug Administration Schedule
Humans
Male
Mandelic Acids / therapeutic use*
Middle Aged
Muscarinic Antagonists / therapeutic use*
Pain Measurement / methods
Pain, Postoperative / etiology,  prevention & control*
Prostatectomy / adverse effects*
Tramadol / administration & dosage
Urinary Catheterization / adverse effects*
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Mandelic Acids; 0/Muscarinic Antagonists; 27203-92-5/Tramadol; 5633-20-5/oxybutynin
Comments/Corrections
Comment In:
Br J Anaesth. 2008 May;100(5):726-7; author reply 727   [PMID:  18407946 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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