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Published in: BMC Anesthesiology 1/2018

Open Access 01-12-2018 | Research article

Preoperative education with image illustrations enhances the effect of tetracaine mucilage in alleviating postoperative catheter-related bladder discomfort: a prospective, randomized, controlled study

Authors: Li Zhou, Le Zhou, Leilei Tian, Daojun Zhu, Ziwen Chen, Chang Zheng, Ting Zhou, Xianzheng Zeng, Xiaojuan Jiang, Chunling Jiang, Lulong Bo

Published in: BMC Anesthesiology | Issue 1/2018

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Abstract

Background

Catheter-related bladder discomfort (CRBD), secondary to catheterization of urinary bladder is distressing. The aim of this study was to assess the efficacy of preoperative education on CRBD with image illustration for alleviating CRBD.

Methods

Sixty adult male patients, undergoing elective colonal and rectal surgery, were randomized to receive tetracaine mucilage instilled into the urethra and applied to the catheter (tetracain group), or receive tetracaine mucilage in combination with image illustration on CRBD (image group) before urethral catheterization. The incidence and severity of CRBD were assessed at 0.5, 1, 2, and 6 h after patients’ extubation. The severity of postoperative pain, incidence of postoperative agitation and other adverse events were also recorded.

Results

Patients in image group reported remarkably less CRBD than those in tetracaine group at 0.5,1, 2 and 6 h after extubation (20, 20, 6.7 and 6.7% v.s. 60, 73.3, 53.3 and 53.3%, respectively, P<0.01). Severe CRBD was not reported in either group. However, the incidence of moderate CRBD was significantly lower in image group, with 6.7% at 1 h and thereafter none occurred, compared to 6.7% at 0.5 h, and increasing to 20% at 1 h, 2 h and 6 h in tetracaine group, respectively. Moreover, patients in image group suffered less moderate to severe postoperative pain than that of tetracaine group (13.3% v.s. 40.0% at 1 h, P = 0.039, 33.3% v.s. 60% at 2 h and 6 h, P = 0.038).

Conclusions

Preoperative education on uretheral catheterization via image illustrations could enhance the effect of tetracaine mucilage in reducing both the incidence and severity of CRBD.

Trial registration

The trial was registered at www,clinicaltrials.gov with registration number NCT03199105 (retrospectively registered). Date of trial registration which is “June 26, 2017”.
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Literature
1.
go back to reference Ryu JH, Hwang JW, Lee JW, Seo JH, Park HP, Oh AY, Jeon YT, Do SH. Efficacy of butylscopolamine for the treatment of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Br J Anaesth. 2013;111(6):932–7.CrossRef Ryu JH, Hwang JW, Lee JW, Seo JH, Park HP, Oh AY, Jeon YT, Do SH. Efficacy of butylscopolamine for the treatment of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Br J Anaesth. 2013;111(6):932–7.CrossRef
2.
go back to reference Agarwal A, Yadav G, Gupta D, Singh PK, Singh U. Evaluation of intra-operative tramadol for prevention of catheter-related bladder discomfort: a prospective, randomized, double-blind study. Br J Anaesth. 2008;101(4):506–10.CrossRef Agarwal A, Yadav G, Gupta D, Singh PK, Singh U. Evaluation of intra-operative tramadol for prevention of catheter-related bladder discomfort: a prospective, randomized, double-blind study. Br J Anaesth. 2008;101(4):506–10.CrossRef
3.
go back to reference Bai Y, Wang X, Li X, Pu C, Yuan H, Tang Y, Li J, Wei Q, Han P. Management of Catheter-Related Bladder Discomfort in patients who underwent elective surgery. J Endourol. 2015;29(6):640–9.CrossRef Bai Y, Wang X, Li X, Pu C, Yuan H, Tang Y, Li J, Wei Q, Han P. Management of Catheter-Related Bladder Discomfort in patients who underwent elective surgery. J Endourol. 2015;29(6):640–9.CrossRef
4.
go back to reference Wilson M. Causes and management of indwelling urinary catheter-related pain. Br J Nurs. 2008;17(4):232–9.CrossRef Wilson M. Causes and management of indwelling urinary catheter-related pain. Br J Nurs. 2008;17(4):232–9.CrossRef
5.
go back to reference Lepouse C, Lautner CA, Liu L, Gomis P, Leon A. Emergence delirium in adults in the post-anaesthesia care unit. Br J Anaesth. 2006;96(6):747–53.CrossRef Lepouse C, Lautner CA, Liu L, Gomis P, Leon A. Emergence delirium in adults in the post-anaesthesia care unit. Br J Anaesth. 2006;96(6):747–53.CrossRef
6.
go back to reference Srivastava VK, Agrawal S, Kadiyala VN, Ahmed M, Sharma S, Kumar R. The efficacy of pregabalin for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled double-blind study. J Anesth. 2015;29(2):212–6.CrossRef Srivastava VK, Agrawal S, Kadiyala VN, Ahmed M, Sharma S, Kumar R. The efficacy of pregabalin for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled double-blind study. J Anesth. 2015;29(2):212–6.CrossRef
7.
go back to reference Agarwal A, Dhiraaj S, Singhal V, Kapoor R, Tandon M. Comparison of efficacy of oxybutynin and tolterodine for prevention of catheter related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Br J Anaesth. 2006;96(3):377–80.CrossRef Agarwal A, Dhiraaj S, Singhal V, Kapoor R, Tandon M. Comparison of efficacy of oxybutynin and tolterodine for prevention of catheter related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Br J Anaesth. 2006;96(3):377–80.CrossRef
8.
go back to reference Tauzin-Fin P, Sesay M, Svartz L, Krol-Houdek MC, Maurette P. Sublingual oxybutynin reduces postoperative pain related to indwelling bladder catheter after radical retropubic prostatectomy. Br J Anaesth. 2007;99(4):572–5.CrossRef Tauzin-Fin P, Sesay M, Svartz L, Krol-Houdek MC, Maurette P. Sublingual oxybutynin reduces postoperative pain related to indwelling bladder catheter after radical retropubic prostatectomy. Br J Anaesth. 2007;99(4):572–5.CrossRef
9.
go back to reference Kim HC, Lee YH, Jeon YT, Hwang JW, Lim YJ, Park JE, Park HP. 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. 2015;32(9):596–601.CrossRef Kim HC, Lee YH, Jeon YT, Hwang JW, Lim YJ, Park JE, Park HP. 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. 2015;32(9):596–601.CrossRef
10.
go back to reference Maghsoudi R, Farhadi-Niaki S, Etemadian M, Kashi AH, Shadpour P, Shirani A, Samadinezhad-Khoshbaf-Sorkhabi R, Tabatabaei M. Comparing the efficacy of Tolterodine and gabapentin versus placebo in catheter related bladder discomfort after percutaneous Nephrolithotomy: a randomized clinical trial. J Endourol. 2018;32(2):168–74.CrossRef Maghsoudi R, Farhadi-Niaki S, Etemadian M, Kashi AH, Shadpour P, Shirani A, Samadinezhad-Khoshbaf-Sorkhabi R, Tabatabaei M. Comparing the efficacy of Tolterodine and gabapentin versus placebo in catheter related bladder discomfort after percutaneous Nephrolithotomy: a randomized clinical trial. J Endourol. 2018;32(2):168–74.CrossRef
11.
go back to reference Mu L, Geng LC, Xu H, Luo M, Geng JM, Li L. Lidocaine-prilocaine cream reduces catheter-related bladder discomfort in male patients during the general anesthesia recovery period: a prospective, randomized, case-control STROBE study. Medicine. 2017;96(14):e6494.CrossRef Mu L, Geng LC, Xu H, Luo M, Geng JM, Li L. Lidocaine-prilocaine cream reduces catheter-related bladder discomfort in male patients during the general anesthesia recovery period: a prospective, randomized, case-control STROBE study. Medicine. 2017;96(14):e6494.CrossRef
12.
go back to reference Yang B, Chen Q, Jiang JH, Liu HL. The comparative study of lidocaine and tetracaine urethral surface anesthesia in catheter related bladder discomfort of male patients after thoracoscopy surgery. J Pract Med. 2017;33(12):2019–202213. Yang B, Chen Q, Jiang JH, Liu HL. The comparative study of lidocaine and tetracaine urethral surface anesthesia in catheter related bladder discomfort of male patients after thoracoscopy surgery. J Pract Med. 2017;33(12):2019–202213.
13.
go back to reference Lin YH, Chen GQ. Analysis about tetracaine hydrochloride mucilage on restless of male patients with urethral catheterization after general anesthesia. Xinjiang Med J. 2017;7:727–9. Lin YH, Chen GQ. Analysis about tetracaine hydrochloride mucilage on restless of male patients with urethral catheterization after general anesthesia. Xinjiang Med J. 2017;7:727–9.
14.
go back to reference Katz J, Poleshuck EL, Andrus CH, Hogan LA, Jung BF, Kulick DI, Dworkin RH. Risk factors for acute pain and its persistence following breast cancer surgery. Pain. 2005;119(1–3):16–25.CrossRef Katz J, Poleshuck EL, Andrus CH, Hogan LA, Jung BF, Kulick DI, Dworkin RH. Risk factors for acute pain and its persistence following breast cancer surgery. Pain. 2005;119(1–3):16–25.CrossRef
15.
go back to reference Ronco M, Iona L, Fabbro C, Bulfone G, Palese A. Patient education outcomes in surgery: a systematic review from 2004 to 2010. Int J Evid Based Healthc. 2012;10(4):309–23.CrossRef Ronco M, Iona L, Fabbro C, Bulfone G, Palese A. Patient education outcomes in surgery: a systematic review from 2004 to 2010. Int J Evid Based Healthc. 2012;10(4):309–23.CrossRef
16.
go back to reference Sjoling M, Nordahl G, Olofsson N, Asplund K. The impact of preoperative information on state anxiety, postoperative pain and satisfaction with pain management. Patient Educ Couns. 2003;51(2):169–76.CrossRef Sjoling M, Nordahl G, Olofsson N, Asplund K. The impact of preoperative information on state anxiety, postoperative pain and satisfaction with pain management. Patient Educ Couns. 2003;51(2):169–76.CrossRef
17.
go back to reference Oshodi TO. The impact of preoperative education on postoperative pain. Part 2. Br J Nurs. 2007;16(13):790–7.CrossRef Oshodi TO. The impact of preoperative education on postoperative pain. Part 2. Br J Nurs. 2007;16(13):790–7.CrossRef
18.
go back to reference Fincher W, Shaw J, Ramelet AS. The effectiveness of a standardised preoperative preparation in reducing child and parent anxiety: a single-blind randomised controlled trial. J Clin Nurs. 2012;21(7–8):946–55.CrossRef Fincher W, Shaw J, Ramelet AS. The effectiveness of a standardised preoperative preparation in reducing child and parent anxiety: a single-blind randomised controlled trial. J Clin Nurs. 2012;21(7–8):946–55.CrossRef
19.
go back to reference Ramesh C, Nayak BS, Pai VB, Patil NT, George A, George LS, Devi ES. Effect of preoperative education on postoperative outcomes among patients undergoing cardiac surgery: a systematic review and meta-analysis. J Perianesth Nurs : official journal of the American Society of PeriAnesthesia Nurses. 2017;32(6):518–29 e512.CrossRef Ramesh C, Nayak BS, Pai VB, Patil NT, George A, George LS, Devi ES. Effect of preoperative education on postoperative outcomes among patients undergoing cardiac surgery: a systematic review and meta-analysis. J Perianesth Nurs : official journal of the American Society of PeriAnesthesia Nurses. 2017;32(6):518–29 e512.CrossRef
20.
go back to reference Choi J. Literature review: using pictographs in discharge instructions for older adults with low-literacy skills. J Clin Nurs. 2011;20(21–22):2984–96.CrossRef Choi J. Literature review: using pictographs in discharge instructions for older adults with low-literacy skills. J Clin Nurs. 2011;20(21–22):2984–96.CrossRef
21.
go back to reference Li JY, Yi ML, Liao R. Dorsal penile nerve block with Ropivacaine-reduced postoperative catheter-related bladder discomfort in male patients after emergence of general anesthesia: a prospective, randomized, controlled study. Medicine (Baltimore). 2016;95(15):e3409.CrossRef Li JY, Yi ML, Liao R. Dorsal penile nerve block with Ropivacaine-reduced postoperative catheter-related bladder discomfort in male patients after emergence of general anesthesia: a prospective, randomized, controlled study. Medicine (Baltimore). 2016;95(15):e3409.CrossRef
22.
go back to reference Riker RR, Picard JT, Fraser GL. Prospective evaluation of the sedation-agitation scale for adult critically ill patients. Crit Care Med. 1999;27(7):1325–9.CrossRef Riker RR, Picard JT, Fraser GL. Prospective evaluation of the sedation-agitation scale for adult critically ill patients. Crit Care Med. 1999;27(7):1325–9.CrossRef
23.
go back to reference Hu B, Li C, Pan M, Zhong M, Cao Y, Zhang N, Yuan H, Duan H. Strategies for the prevention of catheter-related bladder discomfort: a PRISMA-compliant systematic review and meta-analysis of randomized controlled trials. Medicine. 2016;95(37):e4859.CrossRef Hu B, Li C, Pan M, Zhong M, Cao Y, Zhang N, Yuan H, Duan H. Strategies for the prevention of catheter-related bladder discomfort: a PRISMA-compliant systematic review and meta-analysis of randomized controlled trials. Medicine. 2016;95(37):e4859.CrossRef
24.
go back to reference Agarwal A, Dhiraaj S, Pawar S, Kapoor R, Gupta D, Singh PK. An evaluation of the efficacy of gabapentin for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Anesth Analg. 2007;105(5):1454–7 table of contents.CrossRef Agarwal A, Dhiraaj S, Pawar S, Kapoor R, Gupta D, Singh PK. An evaluation of the efficacy of gabapentin for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Anesth Analg. 2007;105(5):1454–7 table of contents.CrossRef
25.
go back to reference Agarwal A, Raza M, Singhal V, Dhiraaj S, Kapoor R, Srivastava A, Gupta D, Singh PK, Pandey CK, Singh U. The efficacy of tolterodine for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Anesth Analg. 2005;101(4):1065–7 table of contents.CrossRef Agarwal A, Raza M, Singhal V, Dhiraaj S, Kapoor R, Srivastava A, Gupta D, Singh PK, Pandey CK, Singh U. The efficacy of tolterodine for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Anesth Analg. 2005;101(4):1065–7 table of contents.CrossRef
Metadata
Title
Preoperative education with image illustrations enhances the effect of tetracaine mucilage in alleviating postoperative catheter-related bladder discomfort: a prospective, randomized, controlled study
Authors
Li Zhou
Le Zhou
Leilei Tian
Daojun Zhu
Ziwen Chen
Chang Zheng
Ting Zhou
Xianzheng Zeng
Xiaojuan Jiang
Chunling Jiang
Lulong Bo
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2018
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-018-0653-y

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