Abstract
Background Catheter-related bladder discomfort (CRBD), an extremely distressing complication secondary to an indwelling urinary catheterization, is frequently reported in patients with transurethral resection of the prostate (TURP), postoperatively. A prospective, randomized, controlled, double-blind study was designed to assess the efficacy of transcutaneous electrical acupoint stimulation (TEAS) as a treatment for CRBD in patients undergoing TURP. Methods Seventy benign prostatic hyperplasia male patients undergoing TURP under general anesthesia requiring intraoperative urinary catheterization were enrolled for the trial. An experienced acupuncturist performed TEAS for 30 minutes before general anesthesia with acupoints RN7, RN6, RN5, RN4, and RN3 and bilateral BL32, BL33, and BL34. Mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SPO2), body temperature (T), and blood samples were collected during the surgery. A series of assessments included the incidence and severity of CRBD, postoperative pain, nausea and vomiting, and physical and mental state measurements. Results The incidence of CRBD was significantly lower in TEAS group than in control group at the time T5 [9(26%) vs. 28(80%), P < 0.001], T9 [20(57%) vs. 28(80%), P=0.039], T11 [7(20%) vs. 31(89%), P < 0.001], and T12 [4(11%) vs. 7(20%), P=0.003]. The severity of CRBD was significantly lower in TEAS group than in control group at the time T5 [0 vs. 10 (29%), P < 0.001], T9 [2(6%) vs. 10(29%), P=0.011], and T11 [0 vs .9(26%), P=0.002]. The QoR-40 total score was higher in TEAS group at time T11 [191.7(4.4) vs. 189.1(4.3), P=0.007] and T12 [195.3(1.9) vs. 193.3(3.0), P < 0.001]. The postoperative analgesia requirement was higher in control group [5.0(2.9) vs. 3.8(1.9), P=0.045]. Conclusions TEAS could significantly prevent the incidence and severity of CRBD, reduce the postoperative analgesic requirement in the early postoperative period, and promote the quality of early recovery in patients undergoing TURP.
Highlights
Urinary catheterization is an extensively used intervention during transurethral resection of the prostate (TURP) frequently leading to a series of discomfort postoperatively
Results. e incidence of Catheter-related bladder discomfort (CRBD) was significantly lower in transcutaneous electrical acupoint stimulation (TEAS) group than in control group at the time T5 [9(26%) vs. 28(80%), P < 0.001], T9 [20(57%) vs. 28(80%), P 0.039], T11 [7(20%) vs. 31(89%), P < 0.001], and T12 [4(11%) vs. 7(20%), P 0.003]. e severity of CRBD was significantly lower in TEAS group than in control group at the time T5 [0 vs. 10 (29%), P < 0.001], T9 [2(6%) vs. 10(29%), P 0.011], and T11 [0 vs .9(26%), P 0.002]. e quality of recovery-40 (QoR-40) total score was higher in TEAS group at time T11 [191.7(4.4) vs. 189.1(4.3), P 0.007] and T12 [195.3(1.9) vs. 193.3(3.0), P < 0.001]. e postoperative analgesia requirement was higher in control group [5.0(2.9) vs. 3.8(1.9), P 0.045]
70 male patients were included in the study, and all the data were collected and analyzed (Figure 2). ere were no significant differences between the two groups for age, heights, weight, body mass index (BMI), time of anesthesia and surgery, intraoperative sufentanil, propofol, remifentanil consumption, and liquid dosage (Table 1)
Summary
Urinary catheterization is an extensively used intervention during transurethral resection of the prostate (TURP) frequently leading to a series of discomfort postoperatively. Catheter-related bladder discomfort (CRBD), an extremely distressing complication secondary to an indwelling urinary catheterization, is frequently reported in patients with transurethral resection of the prostate (TURP), postoperatively. E incidence of CRBD was significantly lower in TEAS group than in control group at the time T5 [9(26%) vs 28(80%), P < 0.001], T9 [20(57%) vs 28(80%), P 0.039], T11 [7(20%) vs 31(89%), P < 0.001], and T12 [4(11%) vs 7(20%), P 0.003]. E severity of CRBD was significantly lower in TEAS group than in control group at the time T5 [0 vs 10 (29%), P < 0.001], T9 [2(6%) vs 10(29%), P 0.011], and T11 [0 vs .9(26%), P 0.002]. TEAS could significantly prevent the incidence and severity of CRBD, reduce the postoperative analgesic requirement in the early postoperative period, and promote the quality of early recovery in patients undergoing TURP
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