Efficacy of IM dexmedetomidine in alleviating catheter related bladder discomfort and postoperative inflammatory response following percutaneous nephrolithotomy. A prospective randomized controlled study.

Abstract

Catheter-related bladder discomfort (CRBD) causes significant distress to the patient and requires great attention to analgesia and increases morbidity in the postoperative period. This study evaluated the efficacy of intramuscular dexmedetomidine in alleviating CRBD following percutaneous nephrolithotomy (PCNL) and postoperative inflammatory response. A prospective randomized double-blind study was conducted in a tertiary care hospital from December 2019- March 2020. Sixty seven of ASA I and II patients scheduled for elective PCNL were randomized and group I received 1 μg/kg dexmedetomidine intramuscularly and group II normal saline as control 30 minutes before induction of anesthesia. Standard anesthesia protocol was followed and patients were catheterized with 16 Fr Foleys after induction of anesthesia. Rescue analgesia was paracetamol if the score was moderate. Postoperatively CRBD score and inflammatory markers; total white cell count, erythrocyte sedimentation rate and temperature were noted for 3 days. There was a significant low CRBD score in group I. Ramsay sedation score was 2 in group I with p 0.00 and rescue analgesia required was very low with p 0.00. Statistical Package for social Sciences software version 20 was used for analysis. Student ttest, analysis of variance, and Chisquare test were applied for quantitative and qualitative analysis respectively. Single dose intramuscular dexmedetomidine is effective, simple and safe in preventing the CRBD and the inflammatory response remained uninfluenced except ESR, the reason remains largely unknown.