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ANESTHETIC PHARMACOLOGY

The Efficacy of Tolterodine for Prevention of Catheter-Related Bladder Discomfort: A Prospective, Randomized, Placebo-Controlled, Double-Blind Study

Anil Agarwal, MD^*, Mehdi Raza, MD^*, Vinay Singhal, MD^*, Sanjay Dhiraaj, MD^*, Rakesh Kapoor, MS, McH, Aneesh Srivastava, MS, McH, Devendra Gupta, MD^*, Prabhat K. Singh, MD^*, Chandra Kant Pandey, MD^*, and Uttam Singh, PhD

Departments of *Anesthesia, Surgical Urology, and Biostatistics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India

Bladder discomfort secondary to an indwelling urinary catheter is distressing, particularly for patients awakening from anesthesia. We sought to discover the incidence and severity of bladder discomfort in patients who were catheterized intraoperatively and to evaluate the efficacy of tolterodine, a pure muscarinic receptor antagonist, in preventing this. Two-hundred-fifteen consecutive adult patients, ASA physical status I and II, either sex, undergoing urologic surgery requiring bladder catheterization were enrolled. Group C (control, n = 165) received placebo and group T (tolterodine, n = 50) received tolterodine 2 mg. Drugs were administered orally 1 h before surgery. After induction of anesthesia, patients were catheterized with a 16F Foley catheter and the balloon was inflated with 10 mL of normal saline. In the postanesthesia care unit, bladder discomfort was assessed on arrival (0), 1, 2 and 6 h. Severity of bladder discomfort was graded as mild, moderate, and severe. Bladder discomfort observed in group C was 55% (91 of 165). Tolterodine reduced both the incidence 36% (18 of 50) and severity of bladder discomfort (P < 0.05).

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