BACKGROUND Male patients undergoing transurethral resection of bladder tumors (TURBT) are prone to suffer from catheter-related bladder discomfort (CRBD). Lidocaine administration has been widely performed to reduce postoperative pain. Here, the effect of intravenous lidocaine administration on moderate-to-severe CRBD was evaluated in male patients undergoing TURBT. METHODS Patients were randomly allocated to receive intravenous lidocaine (1.5 mg/kg bolus dose followed by a 2 mg/kg/h continuous infusion during the intraoperative period, which was continued for 1 hour postsurgery; group L) or placebo (normal saline; group C). The primary outcome was moderate-to-severe CRBD at 0 hour postsurgery (on admission to the postanesthetic care unit), analyzed using the χ test. The secondary outcome was opioid requirement during the 24-hour postoperative period. None, mild, and moderate-to-severe CRBD at 1, 2, and 6 hours postsurgery, postoperative pain, patient satisfaction, side effects of lidocaine and rescue medications (tramadol and fentanyl), and surgical complications were also assessed. RESULTS A total of 132 patients were included in the study (66 patients in each group). The incidence of moderate-to-severe CRBD at 0 hour postsurgery was significantly lower in group L than in group C (25.8% vs 66.7%, P < .001, relative risk: 0.386, 95% confidence interval: 0.248-0.602). Opioid requirements during the 24-hour postoperative period were significantly lower in group L than in group C (10.0 mg [interquartile range (IQR), 5.0-15.0 mg] vs 13.8 mg [IQR, 10.0-20.0 mg], P = .005). At 1 and 2 hours postsurgery (but not at 6 hours), the incidence of moderate-to-severe CRBD was significantly lower in group L than in group C (1 hour: 10.6% vs 27.3%, P = .026; 2 hours: 0.0% vs 15.2%, P = .003). Patient satisfaction was significantly greater in group L than in group C (5.0 [IQR, 4.8-6.0] vs 4.0 [IQR, 4.0-5.0], P < .001). No lidocaine-related side effects were reported. Rescue medication-related side effects and surgical complications did not differ significantly between the 2 groups. CONCLUSIONS Intravenous lidocaine administration resulted in lower incidence of moderate-to-severe CRBD, lower opioid requirement, and higher patient satisfaction in male patients undergoing TURBT without evidence of significant side effects.

中文翻译：

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静脉利多卡因预防经尿道膀胱肿瘤行尿道切除术的男性患者术后导管相关的膀胱不适：一项随机，双盲，对照试验。

背景技术正在经历经尿道膀胱肿瘤切除术（TURBT）的男性患者易于遭受导管相关的膀胱不适（CRBD）。利多卡因给药已被广泛执行以减轻术后疼痛。在此，在接受TURBT治疗的男性患者中评估了静脉注射利多卡因对中度至重度CRBD的影响。方法患者被随机分配在术中接受利多卡因静注（1.5 mg / kg推注剂量，然后连续2 mg / kg / h输注），术后持续1小时； L组）或安慰剂（生理盐水； L组）。 C）。主要结果是术后0小时（入院后麻醉护理室）的CRBD为中度至重度，使用χ检验进行了分析。次要结果是术后24小时内需要阿片类药物。没有评估术后1、2和6小时的CRBD轻度和中度至重度，术后疼痛，患者满意度，利多卡因和急救药物（曲马多和芬太尼）的副作用以及手术并发症。结果本研究共纳入132例患者（每组66例）。L组术后0小时中重度CRBD的发生率显着低于C组（25.8％vs 66.7％，P <.001，相对危险度：0.386，95％置信区间：0.248-0.602）。L组术后24小时的阿片类药物需求量显着低于C组（10.0 mg [四分位间距（IQR），5.0-15.0 mg]比13.8 mg [IQR，10.0-20.0 mg]，P = .005 ）。术后1和2小时（而非6小时），L组中至重度CRBD的发生率显着低于C组（1小时：10.6％vs 27.3％，P = .026； 2小时） ：0.0％和15.2％，P = 0.003）。L组患者的满意度显着高于C组（5.0 [IQR，4.8-6.0] vs 4.0 [IQR，4.0-5.0]，P <.001）。没有报道利多卡因相关的副作用。两组中与药物治疗相关的副作用和手术并发症无明显差异。结论接受利多卡因静脉给药的男性在接受TURBT治疗的男性患者中，中度至重度CRBD发生率较低，阿片类药物需求较低，患者满意度较高，而没有明显的副作用证据。L组中至重度CRBD的发生率显着低于C组（1小时：10.6％比27.3％，P = .026； 2小时：0.0％比15.2％，P = .003）。L组患者的满意度显着高于C组（5.0 [IQR，4.8-6.0] vs 4.0 [IQR，4.0-5.0]，P <.001）。没有报道利多卡因相关的副作用。两组中与药物治疗相关的副作用和手术并发症无明显差异。结论接受利多卡因静脉给药的男性在接受TURBT治疗的男性患者中，中度至重度CRBD发生率较低，阿片类药物需求较低，患者满意度较高，而没有明显的副作用证据。L组中至重度CRBD的发生率显着低于C组（1小时：10.6％比27.3％，P = .026； 2小时：0.0％比15.2％，P = .003）。L组患者的满意度显着高于C组（5.0 [IQR，4.8-6.0] vs 4.0 [IQR，4.0-5.0]，P <.001）。没有报道利多卡因相关的副作用。两组间与药物治疗相关的副作用和手术并发症无明显差异。结论接受利多卡因静脉给药的男性在接受TURBT治疗的男性患者中，中度至重度CRBD发生率较低，阿片类药物需求较低，患者满意度较高，而没有明显的副作用证据。8-6.0] vs 4.0 [IQR，4.0-5.0]，P <.001）。没有报道利多卡因相关的副作用。两组中与药物治疗相关的副作用和手术并发症无明显差异。结论接受利多卡因静脉给药的男性在接受TURBT治疗的男性患者中，中度至重度CRBD发生率较低，阿片类药物需求较低，患者满意度较高，而没有明显的副作用证据。8-6.0] vs 4.0 [IQR，4.0-5.0]，P <.001）。没有报道利多卡因相关的副作用。两组中与药物治疗相关的副作用和手术并发症无明显差异。结论接受利多卡因静脉给药的男性在接受TURBT治疗的男性患者中，中度至重度CRBD发生率较低，阿片类药物需求较低，患者满意度较高，而没有明显的副作用证据。