Preventive effects of butylscopolamine for catheter-related bladder discomfort: a prospective, randomized, multicenter study

Abstract

서론: 도뇨관 삽입 후 발생하는 방광 불편감 (Catheter-related bladder discomfort, CRBD)은 수술 및 마취에서 회복 중인 환자에게 발생하는 심각한 합병증 중 하나이다. 이번 연구에서 항콜린 약물인 butylscopolamine의 전처치가 CRBD의 예방에 미치는 영향을 알아보고자 한다.

방법: 수술 중 요로 도자술이 필요한 수술을 받는 성인 남자 환자를 대상으로 두 군으로 무작위 배정하였다. butylscopolamine 군(n = 49)의 환자들은 기관내튜브 발관 시 butylscopolamine 20mg을 정주하였으며, 대조군(n = 50)의 환자들에게는 아무 약물을 투여하지 않았다. 수술 1, 2, 6시간 후, CRBD의 발생 및 중증도를 평가하였으며, butylscopolamine의 부작용도 함께 평가하였다.

결과: 전체 CRBD의 발생률이 butylscopolamine 군에서 유의하게 낮았다 (P = 0.001). 수술 후 1, 2, 6시간째의 CRBD 발생률도 butylscopolamine 군에서 유의하게 낮았다 (P = 0.006, P = 0.040, P = 0.048). 또한, butylscopolamine 군에서 수술 후 6시간 동안의 평균 CRBD 중증도가 대조군에 비해 유의하게 낮았다 (P = 0.002). 두 군 간 부작용의 발생에는 차이가 없었다.

결론: Butylscopolamine 20 mg 정주로 수술 후 CRBD의 발생률 및 중증도를 효과적으로 줄일 수 있다.

Introduction: Postoperative catheter-related bladder discomfort (CRBD) is a severely distressing complication in patients to whom urinary catheter was inserted during surgery. The present randomized multicenter clinical trial aims to investigate effects of butylscopolamine on prevention of postoperative CRBD in patients undergoing various surgeries.

Methods: Adult male patients undergoing elective surgeries under general anesthesia and requiring intraoperative urinary catheterization were enrolled and randomly assigned to two groups. The butylscopolamine group (n = 49) received butylscopolamine 20 mg intravenously at extubation of an endotracheal tube, whereas no medication was given for prevention of CRBD in the control group (n = 50). The presence and severity of CRBD were assessed at 1, 2 and 6 h after surgery. Adverse effects of butylscopolamine were also examined.

Results: The overall incidence of CRBD was lower in butylscopolamine group than in control group (31% vs. 66%, P = 0.001). The incidences of CRBD at 1, 2 and 6 h after surgery was also lower in butylscopolamine group (P = 0.006, 0.040, and 0.048, respectively). In addition, the average severity of CRBD during 6 hours after surgery was significantly lower in butylscopolamine group (P = 0.002). Adverse effects were comparable between the two groups.

Conclusion: Intravenous administration of butylscopolamine at the end of surgery is effective in reducing the incidence and severity of postoperative CRBD without adverse effects.