Effect of Pregabalin Administration on Catheter- Related Bladder Discomfort in Urological Surgical Operations

Overview

The aim of this study is to assess the effect of pregabalin administration on catheter-related bladder discomfort (CRBD). The study group includes patients that are about to be subjected to urological operations because of the high incidence of CRBD observed in this kind of surgical population.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Prevention
    • Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
  • Study Primary Completion Date: December 31, 2019

Interventions

  • Drug: Placebo oral capsule
    • Placebo oral capsule administered 1 hour prior to the surgical operation
  • Drug: Pregabalin Oral Capsule [Lyrica] 75mg
    • Pregabalin Oral Capsule [Lyrica] 75 mg administered 1 hour prior to the surgical operation
  • Drug: Pregabalin Oral Capsule [Lyrica] 150 mg
    • Pregabalin Oral Capsule [Lyrica] 150 mg administered 1 hour prior to the surgical operation

Arms, Groups and Cohorts

  • Placebo Comparator: Group I
    • Administration of a placebo capsule 1 hour prior to the surgical operation
  • Experimental: Group II
    • Administration of 75mg of pregabalin 1 hour prior to the surgical operation
  • Experimental: Group III
    • Administration of 150mg of pregabalin 1 hour prior to the surgical operation

Clinical Trial Outcome Measures

Primary Measures

  • Percentage of postsurgical catheter-related bladder discomfort after preoperative pregabalin administration
    • Time Frame: Change from preoperative status to postoperative one at 0, 1, 2, 6, 24 hours postoperatively
    • Assessment of discomfort will be made by a scale of four (1=no discomfort, 2=mild discomfort reported on questioning only, 3=moderate discomfort, urge to pass urine reported by the patient without questioning, 4= severe discomfort, urge to pass urine accompanied by behavioral responses, such as flailing limbs, strong vocal responses or attempts to pull the catheter out)

Secondary Measures

  • Postoperative pain assessed by NPRS scale (Numeric Pain Rating Scale)
    • Time Frame: Total amount of analgesics in morphine analogues administered in the first 24 hours postoperatively
    • The goal is to achieve pain scores<3 as these are assessed by the NPRS scale. In order to achieve that we will record the total amount of milligrams of analogues of morphine administered in the first 24 hours postoperatively
  • Adverse effects of the drug
    • Time Frame: All adverse effects observed in the first 24 hours postoperatively
    • Postoperative nausea and vomiting, confusion, vertigo, blurred vision, dry mouth,sedation, dizziness
  • Assessment of postoperative sedation
    • Time Frame: In the operating theatre immediately after patient’s extubation
    • The Ramsay Sedation Scale is used to measure different levels of sedation in medical patients (1=Patient is anxious and agitated or restless, or both 2=Patient is co-operative, oriented, and tranquil, 3=Patient responds to commands only, 4=Patient exhibits brisk response to light glabellar tap or loud auditory stimulus, 5=Patient exhibits a sluggish response to light glabellar tap or loud auditory stimulus, 6=Patient exhibits no response)

Participating in This Clinical Trial

Inclusion Criteria

  • All patients about to be subjected to urinary operations – Signed informed consent Exclusion Criteria:

  • Preoperative urinary bladder/kidney dysfunction as a result of spinal cord pathology – History of overactive ((urinary frequency>3 times at night and >8 times in 24 hours), neurogenic bladder – End stage renal failure – Central nervous system dysfunction – Mental illness/ substance abuse – Sensitivity to pregabalin – Preoperative administration of pregabalin for other indications – Recent bladder catheterization <3 months

Gender Eligibility: All

Minimum Age: 45 Years

Maximum Age: 85 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Saint Savvas Anticancer Hospital
  • Collaborator
    • University of Thessaly
  • Provider of Information About this Clinical Study
    • Principal Investigator: Georgia Micha, Anesthesiologist,MD, MSc, PhD – Saint Savvas Anticancer Hospital
  • Overall Official(s)
    • Eleni Arnaoutoglou, Prof Of Anesthesiology, Study Chair, University of Thessaly, Medical School, Anesthesiology Clinic

References

Agarwal A, Dhiraaj S, Singhal V, Kapoor R, Tandon M. Comparison of efficacy of oxybutynin and tolterodine for prevention of catheter related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Br J Anaesth. 2006 Mar;96(3):377-80. doi: 10.1093/bja/ael003. Epub 2006 Jan 16.

Srivastava VK, Agrawal S, Kadiyala VN, Ahmed M, Sharma S, Kumar R. The efficacy of pregabalin for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled double-blind study. J Anesth. 2015 Apr;29(2):212-6. doi: 10.1007/s00540-014-1911-x. Epub 2014 Sep 9.

Tauzin-Fin P, Stecken L, Sztark F. [Catheter-related bladder discomfort in post-anaesthesia care unit]. Ann Fr Anesth Reanim. 2012 Jul-Aug;31(7-8):605-8. doi: 10.1016/j.annfar.2012.03.009. Epub 2012 Jun 29. French.

Bai Y, Wang X, Li X, Pu C, Yuan H, Tang Y, Li J, Wei Q, Han P. Management of Catheter-Related Bladder Discomfort in Patients Who Underwent Elective Surgery. J Endourol. 2015 Jun;29(6):640-9. doi: 10.1089/end.2014.0670. Epub 2014 Dec 9.

Ryu JH, Hwang JW, Lee JW, Seo JH, Park HP, Oh AY, Jeon YT, Do SH. Efficacy of butylscopolamine for the treatment of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study. Br J Anaesth. 2013 Dec;111(6):932-7. doi: 10.1093/bja/aet249. Epub 2013 Jul 17.

Agarwal A, Gupta D, Kumar M, Dhiraaj S, Tandon M, Singh PK. Ketamine for treatment of catheter related bladder discomfort: a prospective, randomized, placebo controlled and double blind study. Br J Anaesth. 2006 May;96(5):587-9. doi: 10.1093/bja/ael048. Epub 2006 Mar 10.

Agarwal A, Yadav G, Gupta D, Singh PK, Singh U. Evaluation of intra-operative tramadol for prevention of catheter-related bladder discomfort: a prospective, randomized, double-blind study. Br J Anaesth. 2008 Oct;101(4):506-10. doi: 10.1093/bja/aen217. Epub 2008 Jul 24.

Nam K, Seo JH, Ryu JH, Oh AY, Lee T, Park HP, Jeon YT, Hwang JW. Randomized, clinical trial on the preventive effects of butylscopolamine on early postoperative catheter-related bladder discomfort. Surgery. 2015 Feb;157(2):396-401. doi: 10.1016/j.surg.2014.05.017. Epub 2014 Oct 8.

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