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Efficacy of preprocedural diclofenac in men undergoing double J stent removal under local anesthesia: A double-blind, randomized control trial

INTRODUCTION: Double J (DJ) stents are often removed under local anesthesia using a rigid cystoscope. Patients experience significant pain during this procedure and also continue to have discomfort during voiding for a few days. We assessed the efficacy and safety of preemptive oral diclofenac in pa...

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Autores principales: Karthikeyan, Vilvapathy Senguttuvan, Keshavamurthy, Ramaiah, Mallya, Ashwin, Chikka Moga Siddaiah, Manohar, Kumar, Sumit, Chandrashekar, Chulai Rajabahadhur
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5264194/
https://www.ncbi.nlm.nih.gov/pubmed/28197031
http://dx.doi.org/10.4103/0970-1591.194783
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author Karthikeyan, Vilvapathy Senguttuvan
Keshavamurthy, Ramaiah
Mallya, Ashwin
Chikka Moga Siddaiah, Manohar
Kumar, Sumit
Chandrashekar, Chulai Rajabahadhur
author_facet Karthikeyan, Vilvapathy Senguttuvan
Keshavamurthy, Ramaiah
Mallya, Ashwin
Chikka Moga Siddaiah, Manohar
Kumar, Sumit
Chandrashekar, Chulai Rajabahadhur
author_sort Karthikeyan, Vilvapathy Senguttuvan
collection PubMed
description INTRODUCTION: Double J (DJ) stents are often removed under local anesthesia using a rigid cystoscope. Patients experience significant pain during this procedure and also continue to have discomfort during voiding for a few days. We assessed the efficacy and safety of preemptive oral diclofenac in pain relief in patients undergoing DJ stent removal (DJSR) by rigid cystoscopy compared to placebo. METHODS: Consecutive consenting male patients undergoing DJSR under local anesthesia between March 2014 and July 2015 were enrolled. Patients were randomized to receive 75 mg oral diclofenac (Group A) or placebo (Group B) 1 h before procedure by double-blind randomization. Intraurethral 2% lignocaine gel (25 ml) was used in both groups. Pain during rigid cystoscopy, pain at the first void, and at 24 h after cystoscopy was assessed using visual analog scale (VAS) (0–100). Adverse reactions to diclofenac and episodes of acute urinary retention, if any, were assessed (Trial registered at clinicaltrials.gov: NCT02598102). RESULTS: A total of 121 males (Group A [n = 62]; Group B [n = 59]) underwent stent removal. The median (Interquartile range) VAS during the procedure in Group A was 30 (30) and Group B was 60 (30) (P < 0.001), at first void was 30 (30) and 70 (30) (P < 0.001) and at 24 h postoperatively was 20 (20) and 40 (20) (P < 0.001). The incidence of epigastric pain, nausea, vomiting, and acute urinary retention was comparable in the two groups (P > 0.05). CONCLUSIONS: A single oral dose of diclofenac administered 1 h before DJSR using rigid cystoscope under intraurethral lignocaine anesthesia decreases pain significantly during and up to 24 h postprocedure with minimal side effects.
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spelling pubmed-52641942017-02-14 Efficacy of preprocedural diclofenac in men undergoing double J stent removal under local anesthesia: A double-blind, randomized control trial Karthikeyan, Vilvapathy Senguttuvan Keshavamurthy, Ramaiah Mallya, Ashwin Chikka Moga Siddaiah, Manohar Kumar, Sumit Chandrashekar, Chulai Rajabahadhur Indian J Urol Original Article INTRODUCTION: Double J (DJ) stents are often removed under local anesthesia using a rigid cystoscope. Patients experience significant pain during this procedure and also continue to have discomfort during voiding for a few days. We assessed the efficacy and safety of preemptive oral diclofenac in pain relief in patients undergoing DJ stent removal (DJSR) by rigid cystoscopy compared to placebo. METHODS: Consecutive consenting male patients undergoing DJSR under local anesthesia between March 2014 and July 2015 were enrolled. Patients were randomized to receive 75 mg oral diclofenac (Group A) or placebo (Group B) 1 h before procedure by double-blind randomization. Intraurethral 2% lignocaine gel (25 ml) was used in both groups. Pain during rigid cystoscopy, pain at the first void, and at 24 h after cystoscopy was assessed using visual analog scale (VAS) (0–100). Adverse reactions to diclofenac and episodes of acute urinary retention, if any, were assessed (Trial registered at clinicaltrials.gov: NCT02598102). RESULTS: A total of 121 males (Group A [n = 62]; Group B [n = 59]) underwent stent removal. The median (Interquartile range) VAS during the procedure in Group A was 30 (30) and Group B was 60 (30) (P < 0.001), at first void was 30 (30) and 70 (30) (P < 0.001) and at 24 h postoperatively was 20 (20) and 40 (20) (P < 0.001). The incidence of epigastric pain, nausea, vomiting, and acute urinary retention was comparable in the two groups (P > 0.05). CONCLUSIONS: A single oral dose of diclofenac administered 1 h before DJSR using rigid cystoscope under intraurethral lignocaine anesthesia decreases pain significantly during and up to 24 h postprocedure with minimal side effects. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5264194/ /pubmed/28197031 http://dx.doi.org/10.4103/0970-1591.194783 Text en Copyright: © 2017 Indian Journal of Urology http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Karthikeyan, Vilvapathy Senguttuvan
Keshavamurthy, Ramaiah
Mallya, Ashwin
Chikka Moga Siddaiah, Manohar
Kumar, Sumit
Chandrashekar, Chulai Rajabahadhur
Efficacy of preprocedural diclofenac in men undergoing double J stent removal under local anesthesia: A double-blind, randomized control trial
title Efficacy of preprocedural diclofenac in men undergoing double J stent removal under local anesthesia: A double-blind, randomized control trial
title_full Efficacy of preprocedural diclofenac in men undergoing double J stent removal under local anesthesia: A double-blind, randomized control trial
title_fullStr Efficacy of preprocedural diclofenac in men undergoing double J stent removal under local anesthesia: A double-blind, randomized control trial
title_full_unstemmed Efficacy of preprocedural diclofenac in men undergoing double J stent removal under local anesthesia: A double-blind, randomized control trial
title_short Efficacy of preprocedural diclofenac in men undergoing double J stent removal under local anesthesia: A double-blind, randomized control trial
title_sort efficacy of preprocedural diclofenac in men undergoing double j stent removal under local anesthesia: a double-blind, randomized control trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5264194/
https://www.ncbi.nlm.nih.gov/pubmed/28197031
http://dx.doi.org/10.4103/0970-1591.194783
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