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Effect of chlorpheniramine administration on postoperative catheter-related bladder discomfort in patients undergoing transurethral excision of bladder tumor: a prospective randomized study

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Abstract

Purpose

Catheter-related bladder discomfort (CRBD) is postoperative distress caused by a urinary catheter. CRBD is related to muscarinic receptor activation. Chlorpheniramine has antimuscarinic properties. Hence, this investigation was undertaken to evaluate the efficacy of chlorpheniramine in preventing CRBD in patients undergoing transurethral resection of bladder tumor (TURBT).

Methods

Seventy-six patients scheduled for TURBT under general anesthesia were assigned into two groups. In the chlorpheniramine group (n = 38), 100 ml normal saline containing 0.1 mg/kg chlorpheniramine was infused after general anesthesia induction. In the control group (n = 38), 100 ml normal saline alone was infused. The incidence and severity of CRBD were assessed at 1, 6, and 24 h postoperatively.

Results

The 1-h postoperative incidence of CRBD was lower in the chlorpheniramine group based on the unadjusted analysis [16 (42%) vs. 28 (74%), risk difference 32%, 95% confidence interval 8–51, p = 0.005]. After adjusting the size of the urinary catheter, post hoc analysis showed that the 1-h postoperative incidence of CRBD was lower in the chlorpheniramine group (p = 0.004). The CRBD severity score was lower in the chlorpheniramine group at 1 and 6 h after operation based on the unadjusted analysis (p = 0.012 and p = 0.007, respectively). After adjusting the urinary catheter size, post hoc analysis showed that 1- and 6-h CRBD severity score was lower in the chlorpheniramine group (p = 0.012 and p = 0.008, respectively). The incidence of rescue medication was lower in the chlorpheniramine group [10 (26%) vs. 20 (53%), risk difference 26%, 95% confidence interval 3–47, p = 0.019]. The overall incidence of complications such as nausea, vomiting, dry mouth, flushing, dizziness, and blurred vision was comparable between the two groups.

Conclusions

Chlorpheniramine administration significantly reduces the incidence and severity of CRBD in the patients undergoing TURBT.

Trial registration

KCT0004880 (https://cris.nih.go.kr/)

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Acknowledgements

We would like to thank Editage (www.editage.co.kr) for English language editing.

Funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2018R1C1B6007539).

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital At Kangdong, Kyung Hee University College of Medicine, Seoul, Republic of Korea

    Hyub Huh

  2. Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea

    Suk Woo Lee & Jang Eun Cho

  3. Department of Anesthesiology and Pain Medicine, Yonsei University Kangnam Severance Hospital, Yonsei University College of Medicine, 211, Unju-ro, Kangnam-gu, Seoul, 06273, Republic of Korea

    Hyun-Chang Kim

Authors
  1. Hyub Huh
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  2. Suk Woo Lee
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Contributions

Conceptualization: HCK, HH, SWL. Data curation: HH, JEC. Formal analysis: HCK, HH, SWL, JEC. Funding acquisition: HH. Investigation: JEC, SWL. Methodology: HCK, HH, SWL, JEC. Resources: JEC, SWL. Software: HH, HCK. Supervision: HCK. Validation: HH, SWL, JEC. Visualization: HCK. Writing—original draft: HCK, HH. Writing—review and editing: HH, SWL, JEC.

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Correspondence to Hyun-Chang Kim.

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Huh, H., Lee, S.W., Cho, J.E. et al. Effect of chlorpheniramine administration on postoperative catheter-related bladder discomfort in patients undergoing transurethral excision of bladder tumor: a prospective randomized study. J Anesth 35, 646–653 (2021). https://doi.org/10.1007/s00540-021-02970-4

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  • DOI: https://doi.org/10.1007/s00540-021-02970-4

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