Effects of Chlorpheniramine Maleate on Catheter-Related Bladder Discomfort in Patients Undergoing Ureteroscopic Stone Removal: A Randomized Double-Blind Study

In, Chi-Bum; Lee, Seok‐Jin; Sung, Tae‐Yun; Cho, Choon Kyu; Jee, Young Seok

doi:10.7150/ijms.53043

Cited by 6 publications

(4 citation statements)

References 28 publications

(53 reference statements)

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“…Second, previous studies have shown that anti-inflammatory and antimuscarinic agents (e.g., paracetamol, oxybutynin, tolterodine, glycopyrrolate, and butylscopolamine) reduce CRBD [ 20 , 21 ]. However, in a recent study [ 22 ], chlorpheniramine decreased rescue tramadol usage to relieve postoperative CRBD, but did not reduce the incidence or severity of CRBD. The authors speculated that an 8 mg dose of chlorpheniramine is insufficient to reduce CRBD incidence and severity because of its weak antimuscarinic effects [ 7 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, in a recent study [ 22 ], chlorpheniramine decreased rescue tramadol usage to relieve postoperative CRBD, but did not reduce the incidence or severity of CRBD. The authors speculated that an 8 mg dose of chlorpheniramine is insufficient to reduce CRBD incidence and severity because of its weak antimuscarinic effects [ 7 , 22 ]. In addition, chlorpheniramine acts on serotoninergic and cholinergic receptors, which can cause adverse effects, such as dizziness, tinnitus, anxiety, blurred vision, problems with concentration, dry mouth, and difficulty urinating [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Second, in this study, the duration in PACU was not included in the emergence period. Considering that all patients were urinary-catheterized and that chlorpheniramine had little effect on CRBD incidence or severity [ 22 ], it is likely that we underestimated EA incidence and severity in both groups. Third, even though the anesthesia protocols and types of surgery were uniform, individual differences in practice among anesthesiologists and surgeons may have influenced the results.…”

Section: Discussionmentioning

confidence: 99%

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Effects of chlorpheniramine on emergence agitation after general anesthesia for ureteroscopic stone surgery: a retrospective cohort study

et al. 2022

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Background: The presence of a urinary catheter, postoperative pain, and postoperative nausea and vomiting are risk factors for emergence agitation (EA). Antimuscarinic agents are primary agents used in the prevention and treatment of urinary catheter-related bladder discomfort. Chlorpheniramine has antimuscarinic, antinociceptive, and antiemetic effects. This retrospective study investigated the role of chlorpheniramine in EA prevention following ureteroscopic stone surgery.Methods: Of 110 adult patients who underwent ureteroscopic stone surgery under general anesthesia between January and December 2019, the medical records of 93 patients were analyzed retrospectively. The patients were divided into control (n = 52) and chlorpheniramine (n = 41) groups according to the receipt of intravenous chlorpheniramine before the induction of anesthesia. The incidence and severity of EA were compared between the groups as primary and secondary endpoints, respectively. The effects of chlorpheniramine on the requirement for inhalation anesthetic (desflurane) during surgery, changes in mean blood pressure and heart rate during emergence, and adverse events were also compared. Results: The incidence (21.2% in the control group, 24.4% in the chlorpheniramine group) and severity of EA did not differ between groups. The intraoperative requirement for desflurane, changes in mean blood pressure and heart rate during emergence, and adverse events were also similar between groups. Conclusion: Chlorpheniramine was not associated with a decrease in EA incidence or severity in patients who underwent ureteroscopic stone surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effects of chlorpheniramine on emergence agitation after general anesthesia for ureteroscopic stone surgery: a retrospective cohort study

et al. 2022

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“…CRBD was evaluated by the anesthesiology resident: none = no complaints of CRBD symptoms, mild = reported only upon direct inquiry, moderate = spontaneous complaints by the patient without behavioral responses (eg, pulling out the catheter, flailing limbs, or a loud vocal response), and severe = spontaneous complaints by the patient with behavioral responses. 15 An assessment of postoperative delirium was made by trained personnel using the Confusion Assessment Method for the Intensive Care Unit (CAM–ICU) and the Richmond Agitation-Sedation Scale (RASS) from the first to the third postoperative day. 16 A patient was considered delirious if he or she was awake (RASS of 3 or greater) and positive for CAM-ICU on either of the CAM–ICU assessments.…”

Section: Methodsmentioning

confidence: 99%

Effect of Transcutaneous Acupoint Electrical Stimulation on Urinary Retention and Urinary ATP in Elderly Patients After Laparoscopic Cholecystectomy: A Prospective, Randomized, Controlled Clinical Trial

Zhang¹,

Gong²,

Zhang³

et al. 2022

CIA

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Purpose To investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on urinary retention after laparoscopic cholecystectomy in elderly patients, and to explore the relationship between TEAS and urinary ATP. Patients and Methods The TEAS group was administered active TEAS at specific acupuncture points prior to induction of anesthesia and continued for 45 mins after surgery. In the control group, participants received sham stimulus at the same acupoints and no output current was delivered by disconnecting the device’s output line. Urine samples were collected and evaluated in the first spontaneous voiding after surgery. In this study, postoperative urinary retention (POUR) was the primary outcome, which was diagnosed based on clinical symptoms, ultrasound assessments, and the need for bladder catheterization. Secondary outcomes include urinary ATP, postoperative spontaneous urination, urination symptoms, catheter-related bladder discomfort (CRBD), delirium, duration and hospitalization costs. Results The study involved 598 patients recruited and randomized between August 2018 and June 2020. Among these patients, 547 (91.5%) completed the study and were analyzed. There were 64 cases of POUR, including 23 (8.4%, 95% confidence interval [CI]: 6.4–9.9%) in the TEAS group and 41 (15.0%, 95% CI: 9.3–13.4%) in the control group (p = 0.017). A significant difference was observed between the TEAS and control groups for urinary ATP concentration in the first spontaneous urine postoperatively (344 nmol/L versus 233 nmol/L, p=0.001). There was a shorter spontaneous voiding recovery time, smaller voiding threshold, less postoperative catheterization, less CRBD, and lower hospitalization costs in TEAS group compared with control group. Conclusion TEAS reduces the incidence of POUR in elderly patients undergoing laparoscopic cholecystectomy, which may be related to an increase in bladder ATP release.

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Different interventions for preventing postoperative catheter-related bladder discomfort: a systematic review and meta-analysis

Wang

et al. 2022

Eur J Clin Pharmacol

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Effects of Chlorpheniramine Maleate on Catheter-Related Bladder Discomfort in Patients Undergoing Ureteroscopic Stone Removal: A Randomized Double-Blind Study

Cited by 6 publications

References 28 publications

Effects of chlorpheniramine on emergence agitation after general anesthesia for ureteroscopic stone surgery: a retrospective cohort study

Effects of chlorpheniramine on emergence agitation after general anesthesia for ureteroscopic stone surgery: a retrospective cohort study

Effect of Transcutaneous Acupoint Electrical Stimulation on Urinary Retention and Urinary ATP in Elderly Patients After Laparoscopic Cholecystectomy: A Prospective, Randomized, Controlled Clinical Trial

Different interventions for preventing postoperative catheter-related bladder discomfort: a systematic review and meta-analysis

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