Tetracaine hydrochloride gel delays and reduces catheter-related bladder discomfort after transurethral resection: a randomized controlled trial.
Yang Liu, Ling Li, Jingjin Li et al.
✦ AI-curated · Sources linked
In 30 seconds
This randomized, single-blind trial compared tetracaine hydrochloride gel with standard lubricant in 130 patients undergoing transurethral resection. Gel was applied to the catheter before insertion, and investigators assessed moderate-to-severe catheter-related bladder discomfort (CRBD) after extubation. Among patients who developed CRBD, median time to first moderate-to-severe symptoms was 30 [10.0-61.3] min with tetracaine versus 5 [4.8-10.0] min with control (p < 0.001). New-onset CRBD was also less frequent with tetracaine over 24 hours, although incidence rose transiently between 30 and 120 minutes.
Key findings
- New-onset moderate-to-severe CRBD within 30 min occurred in 15 [23.1%] with tetracaine versus 43 [66.2%] with control (p < 0.001).
- Across the 24-hour assessment, moderate-to-severe CRBD occurred in 30 [46.2%] versus 46 [70.8%] (p = 0.004).
- Between 30-120 min, new-onset CRBD was more frequent with tetracaine: 11 [16.9%] versus 2 [3.1%] (p = 0.016).
- Six-hour satisfaction was higher and postoperative pain scores were lower with tetracaine; analgesic requirements did not differ significantly.
Why it matters
CRBD can cause substantial postoperative discomfort, while systemic analgesics and anticholinergics may have adverse effects. This trial suggests that applying a topical anesthetic to the catheter can reduce and delay moderate-to-severe symptoms, with improved satisfaction and lower pain scores. The transient increase in symptoms later in the early postoperative period is relevant when interpreting the overall benefit.
What to keep in mind
The study was single-blind and assessed patients undergoing transurethral resection; the abstract does not establish whether findings generalize to other procedures or settings.