Lokal anestezi altında sistoskopide işlem öncesi analjezi kullanımının hasta ve doktor konforuna etkisi: Prospektif randomize çift kör plasebo kontrollü çalışma


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Uçar T., İplikçi A., Kazan H. Ö. , Yıldırım A.

28. Ulusal Üroloji Kongresi, Antalya, Türkiye, 10 - 13 Ekim 2019, ss.3-4

  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayısı: ss.3-4

Özet

INTRODUCTION: Cystoscopy is one of the most common procedure in urology. It is used as a decision-making method for first diagnosis or during follow-up of malignancies. But it can be very painful and uncomfortable for the patients under local anesthesia. According to literature, non-steroid anti-inflammatory drugs can be used for pain relief before the procedure. So, we conducted this study to compare two groups of patients, which are placebo and intervention, in order to define effect of pain killers on; pain during and after the procedure, dysuria, frequency and comfort of the doctor during the procedure. In this abstract we shared preliminary results of our study with 100 patients.

MATERIAL-METHOD: The study is approved by our ethical committee and registered to clinicaltrials.gov (ClinicalTrials.gov Identifier: NCT03831321). It was designed as a prospective, randomized double-blind placebo controlled trial. According to power analysis using a total of 144 patients are needed for Power: 80% and Efficacy: 0.05. Diclofenac (50 mg) and placebo drugs to be used in the study was numbered as 1 and 2 respectively. Patient randomization was performed using random.org in 144 patients. On the day of the cystoscopy a closed medication envelope which is marked 1 for diclofenac sodium and 2 for placebo, was given the patient 1 hour before the procedure according to randomization. All procedures were made by an experienced physician. All procedure was taken with rigid cystoscope. Assessment of pain was made with Visual Pain Scale (VPS). In order to assess comfort of the surgeon during the procedure a scale has been created which is rated as 1 to 5.

RESULTS: Total of 100 patients are included our study. We had 52 patients versus 48 patients for group 1 and group 2 respectively. Two groups were comparable in regards of age, gender body mass index, during and post-operative 1st hour VPS, post-operative 24th hour dysuria and frequency. Comfort of the surgeon during the procedure was comparable between two groups (p= 0.451). Post-operative 1st hour dysuria and frequency were less likely to be seen in group 1 than group 2 (p= 0.043, p= 0.010). During study, one cystoscopy was defined as an inadequate procedure from group 2 and the patient was directed to cystoscopy under general anesthesia. CONCLUSION: According to our first results, preemptive analgesia usage before cystoscopy under local anesthesia is helpful for post-operative first hour dysuria and frequency complaints. But it has no effect on comfort of surgeon, pain and post-operative 24th hour dysuria and frequency.