Transcutaneous electrical nerve stimulation and catheter-related bladder discomfort following transurethral resection of bladder tumour: A randomised controlled trial.

IF 4.2 2区 医学 Q1 ANESTHESIOLOGY
Jun-Young Park, Jihion Yu, Chan-Sik Kim, Ji-Won Baek, Taeho Mun, Young-Kug Kim
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引用次数: 0

Abstract

Background: Catheter-related bladder discomfort (CRBD) is problematic in patients with a urinary catheter. Transcutaneous electrical nerve stimulation (TENS) is a non-invasive analgesic modality used to relieve various types of pain.

Objectives: We evaluated the effect of TENS on CRBD after transurethral resection of bladder tumours (TURBT).

Design: A randomised controlled trial.

Setting: A large university tertiary hospital, from October 2022 to March 2023.

Patients: Patients requiring urinary catheterisation after TURBT.

Intervention: In this randomised controlled trial, patients were randomly allocated to the TENS (n  = 56) or control (n  = 56) groups. CRBD manifests as a burning sensation with an urge to void or discomfort in the suprapubic area. Moderate to severe CRBD was defined as patients self-reporting CRBD symptoms with or without behavioural response, including attempts to remove the urinary catheter, intense verbal reactions, and flailing limbs. TENS was performed from the end of surgery to 1 h postoperatively.

Main outcome measure: The primary endpoint was considered moderate to severe CRBD immediately postoperatively. Secondary endpoints included moderate to severe CRBD at 1, 2 and 6 h postoperatively. Additionally, postoperative pain, patient satisfaction, and TENS-related adverse effects were evaluated.

Results: Moderate to severe CRBD immediately postoperatively was significantly less frequent in the TENS group than in the control group: 10 (17.9%) vs. 34 (60.7%); P < 0.001; relative risk (95% CI) = 0.294 (0.161 to 0.536); absolute risk reduction = 0.43; number needed to treat = 2.3. Moderate to severe CRBD differed between the two groups at 1 h postoperatively: 1 (1.8%) vs. 16 (28.6%); P < 0.001; relative risk = 0.06 (95% CI 0.01 to 0.46); absolute risk reduction = 0.27; number needed to treat = 3.7. The TENS group exhibited a significantly lower score for postoperative pain at 1 h (1.8 ± 0.6 vs. 2.2 ± 0.4; P < 0.001, mean difference (95% CI) = 0.4 (0.2 to 0.6) and a higher score for patient satisfaction, 5.0 (4.0 to 6.0) vs. 3.0 (3.0 to 4.0); P < 0.001; median difference (95% CI) = 2.0 (1.0 to 2.0).

Conclusions: TENS reduced moderate to severe CRBD, decreased postoperative pain, and increased patient satisfaction after TURBT.

Clinical trial registry: Clinical Research Information Service (KCT0007450).

Visual abstract: http://links.lww.com/EJA/B12.

经皮神经电刺激与经尿道膀胱肿瘤切除术后导尿管相关的膀胱不适:随机对照试验。
背景:导尿管相关性膀胱不适(CRBD)是使用导尿管患者的常见问题。经皮神经电刺激(TENS)是一种非侵入性镇痛方式,用于缓解各种疼痛:我们评估了经尿道膀胱肿瘤切除术(TURBT)后 TENS 对 CRBD 的影响:设计:随机对照试验:一家大型大学三级医院,2022年10月至2023年3月:患者:TURBT术后需要导尿的患者:在这项随机对照试验中,患者被随机分配到 TENS 组(56 人)或对照组(56 人)。CRBD表现为耻骨上区域的灼烧感、排尿冲动或不适感。中度至重度 CRBD 的定义是患者自我报告的 CRBD 症状伴有或不伴有行为反应,包括试图拔出导尿管、强烈的言语反应和四肢乱动。从手术结束到术后1小时进行TENS治疗。主要结果测量:主要终点为术后即刻出现的中度至重度CRBD。次要终点包括术后 1、2 和 6 小时的中度至重度 CRBD。此外,还对术后疼痛、患者满意度和 TENS 相关不良反应进行了评估:结果:术后即刻出现中度至重度 CRBD 的 TENS 组明显少于对照组:10 (17.9%) vs. 34 (60.7%);P 结论:TENS 可减少中度至重度 CRBD:TENS可减少TURBT术后中度至重度CRBD、减轻术后疼痛并提高患者满意度:临床研究信息服务(KCT0007450)。视觉摘要:http://links.lww.com/EJA/B12。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.90
自引率
11.10%
发文量
351
审稿时长
6-12 weeks
期刊介绍: The European Journal of Anaesthesiology (EJA) publishes original work of high scientific quality in the field of anaesthesiology, pain, emergency medicine and intensive care. Preference is given to experimental work or clinical observation in man, and to laboratory work of clinical relevance. The journal also publishes commissioned reviews by an authority, editorials, invited commentaries, special articles, pro and con debates, and short reports (correspondences, case reports, short reports of clinical studies).
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