Naloxegol and Postoperative Urinary Retention: A Randomized Trial

被引:0
|
作者
Turan, Alparslan [1 ,2 ]
Fang, Jonathan [1 ]
Esa, Wael Ali Sakr [1 ,2 ]
Hamadnalla, Hassan [1 ,3 ]
Leung, Steve [1 ]
Pu, Xuan [1 ,4 ]
Raza, Syed [1 ]
Chelnick, David [1 ]
Mounir Soliman, Loran [2 ]
Seif, John [2 ]
Ruetzler, Kurt [1 ,2 ]
Sessler, Daniel I. [1 ]
机构
[1] Cleveland Clin, Dept Outcomes Res, Cleveland, OH 44195 USA
[2] Cleveland Clin, Dept Gen Anesthesiol, Cleveland, OH 44195 USA
[3] Henry Ford Hlth Syst, Pain Management & Perioperat Med, Dept Anesthesiol, Detroit, MI 48202 USA
[4] Cleveland Clin, Dept Quantitat Hlth Sci, Cleveland, OH 44195 USA
关键词
anesthesia; urinary retention; naloxegol; residual bladder urine volume; RISK-FACTORS; ARTHROPLASTY; NALOXONE; QUALITY;
D O I
10.3390/jcm11020454
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Naloxegol antagonizes peripheral opioid-related side effects without preventing opioid-related analgesia. However, the effect of naloxegol on opioid-induced bladder dysfunction remains unknown. Hypothesis: patients given naloxegol have lower residual bladder urine volume than those given placebo. Methods: 136 patients scheduled for elective hip and knee surgery were randomized to oral naloxegol or placebo given the morning of surgery, and on the first two postoperative mornings. Residual urine volume was measured ultrasonographically within 30 min after voiding once in the morning and once in the afternoon for two postoperative days. Opioid-related Symptom Distress Scale (ORSDS), the need for indwelling urinary catheterization, and quality of recovery (QoR) score were secondary outcomes. Results: 67 were randomized to naloxegol and 64 to placebo. We did not identify a significant effect on urine residual volume, with an estimated ratio of geometric means of 0.9 (0.3, 2.6), p = 0.84. There were no significant differences in ORSDS or QoR. There were 19 (29%) patients assigned to naloxegol who needed indwelling urination catheterization versus 7 (11%) patients in the placebo group, p = 0.012. Conclusions: Our results do not support use of naloxegol for postoperative urinary retention after hip and knee surgery.
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页数:10
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