Indian journal of anaesthesia · 2025
Pre-emptive role of oral melatonin in prevention of catheter-related bladder discomfort (CRBD) in patients undergoing transurethral resection of prostate (TURP) surgery: A randomised controlled study.
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Kumar A Dinesh, Rath Amrita, Kumar Ujwal, Reena, Anand Neelesh
Аннотация
BACKGROUND AND AIMS: Catheter-related bladder discomfort (CRBD) is a frequent and distressing complication following urological procedures such as transurethral resection of the prostate (TURP). Melatonin may reduce CRBD. This study aimed to evaluate the efficacy of pre-emptive oral melatonin in reducing CRBD in patients undergoing TURP.
METHODS: Seventy male patients aged 40-65 years scheduled for TURP under spinal anaesthesia were enroled in this randomised controlled trial. Group M received oral melatonin 5 mg the night before and the morning of surgery, while Group C received oral vitamin C 5 mg as a placebo. CRBD incidence and severity were assessed at 0, 2, 8, 12, and 24 h postoperatively. Sedation using the Ramsay sedation scale (RSS), patient satisfaction scale (PSS), surgeon satisfaction scale (SSS), and need for rescue analgesia was assessed. Statistical tests were two-tailed with a significance level set at P < 0.05.
RESULTS: The incidence of CRBD was significantly reduced at 24 h in Group M as compared to Group C (P = 0.001, Absolute risk reduction = 48.57%, Relative risk reduction = 45.1%, Number needed to treat = 2.06). Similarly, the incidences were also reduced at 2, 8, and 12 h (P = 0.005, P = 0.004, and P < 0.001, respectively). No significant differences in sedation levels, PSS, SSS, and RSS were noted between the groups. The need for paracetamol in the postoperative period was significantly higher in Group C than in Group M (P = 0.0006).
CONCLUSION: Preemptive oral melatonin effectively reduces the incidence and severity of postoperative CRBD in patients undergoing TURP.
METHODS: Seventy male patients aged 40-65 years scheduled for TURP under spinal anaesthesia were enroled in this randomised controlled trial. Group M received oral melatonin 5 mg the night before and the morning of surgery, while Group C received oral vitamin C 5 mg as a placebo. CRBD incidence and severity were assessed at 0, 2, 8, 12, and 24 h postoperatively. Sedation using the Ramsay sedation scale (RSS), patient satisfaction scale (PSS), surgeon satisfaction scale (SSS), and need for rescue analgesia was assessed. Statistical tests were two-tailed with a significance level set at P < 0.05.
RESULTS: The incidence of CRBD was significantly reduced at 24 h in Group M as compared to Group C (P = 0.001, Absolute risk reduction = 48.57%, Relative risk reduction = 45.1%, Number needed to treat = 2.06). Similarly, the incidences were also reduced at 2, 8, and 12 h (P = 0.005, P = 0.004, and P < 0.001, respectively). No significant differences in sedation levels, PSS, SSS, and RSS were noted between the groups. The need for paracetamol in the postoperative period was significantly higher in Group C than in Group M (P = 0.0006).
CONCLUSION: Preemptive oral melatonin effectively reduces the incidence and severity of postoperative CRBD in patients undergoing TURP.