Abstract
BackgroundUrinary catheterization is universally used during surgery, and the incidence of postoperative catheter-related bladder discomfort (CRBD) is very high during recovery. We conducted this study to identify the incidence and predictors of postoperative CRBD after gynaecological surgery in the post-anesthesia care unit (PACU).MethodsThis was a prospective observational study. Patients undergoing gynaecological surgery under general anesthesia with intra-operative urinary catheterization were enrolled. We collected the clinical data, incidence and severity of CRBD, and postoperative pain for the patients. Predictive factors of CRBD were analysed by univariate and multivariate analysis.ResultsA total of 407 patients were included in this study. The incidence of CRBD after gynaecological surgery was 64.6% (mild CRBD: 22.8%; moderate CRBD: 34.2%; and severe CRBD: 7.6%). Univariate analysis showed that age, type of surgery, type of laparoscopic surgery, additional analgesics, and postoperative pain were influencing factors for CRBD. Based on multivariate logistic regression analysis, age ≥ 50 years, uterus-related laparoscopic surgery, and lack of additional analgesics were independent predictors of moderate or severe CRBD.ConclusionsThis observational study revealed that the incidence of CRBD after gynaecological surgery in PACU was very high. Age ≥ 50 years, uterus-related laparoscopic surgery, and lack of additional analgesics were independent predictors of CRBD.Trial registrationChiCTR1800016390. Registered on 30 May 2018.
Highlights
Urinary catheterization is universally used during surgery, and the incidence of postoperative catheter-related bladder discomfort (CRBD) is very high during recovery
There is a study showing that abdominal open surgery and a history of catheterization 3 months prior to the operation are independent predictors of CRBD after urological surgery [5]
We evaluated the severity of CRBD and postoperative pain
Summary
This prospective observational study was approved by the China Ethics Committee of Registering Clinical Trials, and registered in the Chinese Clinical Trial Registry (ChiCTR1800016390) It was implemented in West China Second Hospital of Sichuan University from June to July 2018. Lornoxicam and tramadol were common used as additional analgesia administered near the end of operation for postoperative pain according to anesthetists’ own habit without consideration of the effects on CRBD. In the PACU, we collected clinical data for the patients, including age, sufentanil dosage, surgery duration time, type of surgery, type of laparoscopic surgery, occasion of catheterization (before anaesthesia or after anaesthesia), additional analgesics near the end of the operation, intraoperative atropine, and postoperative neostigmine and atropine. Patients were divided into groups according to the incidence and severity of CRBD. All the data were analyzed by using SPSS 17.0, and P < 0.05 was considered significant
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