Dose-dependent effect and effective dose of nefopam to prevent catheter-related bladder discomfort in patients undergoing transurethral ureteroscopic lithotripsy: a retrospective case-control observational study

Abstract

Abstract Background Patients with Foley catheter may experience catheter-related bladder discomfort (CRBD) after surgery. Previous studies have indicated that nefopam can reduce the incidence and severity of CRBD; however, they could not compare dose-dependent effects (20 mg vs. 40 mg). Therefore, we aimed to investigate the dose-dependent effects, effective dose of nefopam for CRBD, and the incidence of side effects. Methods From August 2016 to December 2022, we reviewed the electronic medical records of patients aged 18–70 years with American Society of Anesthesiologists physical status I-III who underwent elective transurethral ureteroscopic lithotripsy under general anesthesia. Patients were either administered premedication to prevent CRBD (intravenous nefopam 20 mg, group N20, or 40 mg, group N40) or not (group C). Results The incidence of CRBD were 85.7% in Group C, 81.3% in Group N20, and 24.3% in Group N40. There was a significant difference in the incidence between the groups (P = 0.0034). As the dose of nefopam increased, the incidence of CRBD decreased linearly, and the difference was statistically significant (P = 0.002). In the trend test, severity also decreased as the dose of nefopam increased, which was statistically significant (P < 0.001). Evaluation of hemodynamic stability during surgery and postoperative nausea and vomiting showed no significant differences among the three groups. Conclusions Nefopam 40 mg reduced both the incidence and severity of CRBD compared to the control group. Trial registration number: ID- KCT0008381 (https://trialsearch.who.int/Trial2.aspx?TrialID=KCT0008381) Date of registration – 2023-04-25