Abstract PR514

Abstract

Background & Objectives: Catheter-related bladder discomfort (CRBD) secondary to an indwelling urinary catheter is defined as a burning sensation at urethra with an urge to void, urinary frequency and discomfort in the supra-public region, which decreases the quality of postoperative recovery. The aim of this study was to evaluate if nerve stimulator-guided bilateral pudendal nerve block could relieve CRBD in male patients undergoing lower urinary tract surgeries. Materials & Methods: One hundred and seventy-eight adult male patients undergoing elective transurethral resection of prostate(TURP) and transurethral resection of bladder tumor(TURBT) under general anesthesia were randomly allocated into 2 groups: pudendal group (Group P=89)) and control group (Group C=89. Pudendal group received general anesthesia combined with nerve stimulator-guided bilateral pudendal nerve block (0.5% ropivacaine 10ml each side) and control group received general anesthesia alone. The incidence and severity of CRBD, and postoperative pain (visual analogue scale, VAS) were assessed at 30min, 2h, 8h, 12h and 24h postoperatively. The patients were also observed for heart rate and mean blood pressure in the following time: baseline (T1), cystoscope entering into the urethra (T2) and resection beginning (T3), extubation (T4) and 30min postoperatively (T5). Results: The incidence of CRBD was significantly lower in pudendal group at 30min (63% vs 82%, p=0.004), 2h (64% vs 90%, p<0.000), 8h (58% vs 79%, p=0.003) and 12h (52% vs 69%, p=0.028) postoperatively. The incidence of moderate to severe CRBD was also significantly lower in pudendal group at 30min (29% vs 57%, p<0.001), 2h (22% vs 55%, p<0.000), 8h (8% vs 27%, p=0.001) and 12h (6% vs 16%, p=0.035) postoperatively. The postoperative pain score was lower in pudendal group at 30min (p=0.003), 2h (p<0.001), 8h (p<0.001) and 12h (p<0.001) postoperatively. Heart rate and mean blood pressure were lower in pudendal group at cystoscope entering into the urethra (T2) and resection beginning intraoperatively (T3), extubation (T4) and 30min postoperatively (T5). The number of patients required additional opioids intraoperatively was higher in the control group {22 (25%) vs 8 (9%), p=0.012}.Postoperative rescue drugs were required more in the control group, analgesic 13 (15%) vs 4 (5%), p=0.026; antispasmodic drug 17 (19%) vs 7 (8%), p=0.035}. Conclusion: General anesthesia combined with nerve stimulator-guided bilateral pudendal nerve block with 0.5% ropivacaine 10ml each side decreased the incidence and severity of CRBD for the first 12 hours postoperatively as well as intraoperative additional opioids and postoperative rescue drugs requirements in male patients undergoing TURP and TURBT. Disclosure of Interest: None declared