Cargando…
Prophylactic doxazosin reduces urinary retention and promotes recovery after total joint arthroplasty: A randomized controlled trial
Background: Postoperative urinary retention (POUR) is a common and disruptive complication following total joint arthroplasty (TJA). The aim of this study is to investigate whether doxazosin can decrease the incidence of POUR and promote recovery under the setting of modern enhanced recovery after T...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868269/ https://www.ncbi.nlm.nih.gov/pubmed/36699090 http://dx.doi.org/10.3389/fphar.2022.1016203 |
_version_ | 1784876495587508224 |
---|---|
author | Ding, Zichuan Cao, Jian Huang, Chao Zhou, Kai Wang, Haoyang Zhou, Zongke |
author_facet | Ding, Zichuan Cao, Jian Huang, Chao Zhou, Kai Wang, Haoyang Zhou, Zongke |
author_sort | Ding, Zichuan |
collection | PubMed |
description | Background: Postoperative urinary retention (POUR) is a common and disruptive complication following total joint arthroplasty (TJA). The aim of this study is to investigate whether doxazosin can decrease the incidence of POUR and promote recovery under the setting of modern enhanced recovery after TJA. Methods: In this randomized placebo-controlled trial, patients over 35 years of age undergoing primary unilateral TJA were recruited. Patients received doxazosin (4 mg once) or placebo 2 h before surgery. The primary outcome of interest was the development of POUR, which was diagnosed when patients with a urine volume over 400 ml or overflow incontinence. Postoperative recovery was assessed in terms of hospital length of stay after surgery, daily ambulation distance, visual analogue scale (VAS) pain score and opioid consumption. Results: A total of 170 male patients were equally randomized into Doxazosin group (mean age 54.2 ± 13.7 years, range 36–88 years) and Placebo group (mean age 54.6 ± 13.9 years, range 38–81 years). The POUR rate was significant lower in Doxazosin group (17.6%) than in Placebo group (36.5%) (p = .006). The mean LOS in the Doxazosin group was 3.1 ± 1.1 days compared to 3.6 ± 1.7 days in the Placebo group (p = .030). Doxazosin group had a longer daily mobilization distance than Placebo group on postoperative day 1 (26.8 ± 11.1 vs. 22.8 ± 9.7; p = .015). Postoperative pain assessed by VAS score and opioid usage was comparable between two groups. Conclusion: Our results support the routine use of prophylactic doxazosin in male patients to decrease POUR rate and promote postoperative recovery under the setting of modern enhanced recovery after TJA. |
format | Online Article Text |
id | pubmed-9868269 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98682692023-01-24 Prophylactic doxazosin reduces urinary retention and promotes recovery after total joint arthroplasty: A randomized controlled trial Ding, Zichuan Cao, Jian Huang, Chao Zhou, Kai Wang, Haoyang Zhou, Zongke Front Pharmacol Pharmacology Background: Postoperative urinary retention (POUR) is a common and disruptive complication following total joint arthroplasty (TJA). The aim of this study is to investigate whether doxazosin can decrease the incidence of POUR and promote recovery under the setting of modern enhanced recovery after TJA. Methods: In this randomized placebo-controlled trial, patients over 35 years of age undergoing primary unilateral TJA were recruited. Patients received doxazosin (4 mg once) or placebo 2 h before surgery. The primary outcome of interest was the development of POUR, which was diagnosed when patients with a urine volume over 400 ml or overflow incontinence. Postoperative recovery was assessed in terms of hospital length of stay after surgery, daily ambulation distance, visual analogue scale (VAS) pain score and opioid consumption. Results: A total of 170 male patients were equally randomized into Doxazosin group (mean age 54.2 ± 13.7 years, range 36–88 years) and Placebo group (mean age 54.6 ± 13.9 years, range 38–81 years). The POUR rate was significant lower in Doxazosin group (17.6%) than in Placebo group (36.5%) (p = .006). The mean LOS in the Doxazosin group was 3.1 ± 1.1 days compared to 3.6 ± 1.7 days in the Placebo group (p = .030). Doxazosin group had a longer daily mobilization distance than Placebo group on postoperative day 1 (26.8 ± 11.1 vs. 22.8 ± 9.7; p = .015). Postoperative pain assessed by VAS score and opioid usage was comparable between two groups. Conclusion: Our results support the routine use of prophylactic doxazosin in male patients to decrease POUR rate and promote postoperative recovery under the setting of modern enhanced recovery after TJA. Frontiers Media S.A. 2023-01-09 /pmc/articles/PMC9868269/ /pubmed/36699090 http://dx.doi.org/10.3389/fphar.2022.1016203 Text en Copyright © 2023 Ding, Cao, Huang, Zhou, Wang and Zhou. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pharmacology Ding, Zichuan Cao, Jian Huang, Chao Zhou, Kai Wang, Haoyang Zhou, Zongke Prophylactic doxazosin reduces urinary retention and promotes recovery after total joint arthroplasty: A randomized controlled trial |
title | Prophylactic doxazosin reduces urinary retention and promotes recovery after total joint arthroplasty: A randomized controlled trial |
title_full | Prophylactic doxazosin reduces urinary retention and promotes recovery after total joint arthroplasty: A randomized controlled trial |
title_fullStr | Prophylactic doxazosin reduces urinary retention and promotes recovery after total joint arthroplasty: A randomized controlled trial |
title_full_unstemmed | Prophylactic doxazosin reduces urinary retention and promotes recovery after total joint arthroplasty: A randomized controlled trial |
title_short | Prophylactic doxazosin reduces urinary retention and promotes recovery after total joint arthroplasty: A randomized controlled trial |
title_sort | prophylactic doxazosin reduces urinary retention and promotes recovery after total joint arthroplasty: a randomized controlled trial |
topic | Pharmacology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868269/ https://www.ncbi.nlm.nih.gov/pubmed/36699090 http://dx.doi.org/10.3389/fphar.2022.1016203 |
work_keys_str_mv | AT dingzichuan prophylacticdoxazosinreducesurinaryretentionandpromotesrecoveryaftertotaljointarthroplastyarandomizedcontrolledtrial AT caojian prophylacticdoxazosinreducesurinaryretentionandpromotesrecoveryaftertotaljointarthroplastyarandomizedcontrolledtrial AT huangchao prophylacticdoxazosinreducesurinaryretentionandpromotesrecoveryaftertotaljointarthroplastyarandomizedcontrolledtrial AT zhoukai prophylacticdoxazosinreducesurinaryretentionandpromotesrecoveryaftertotaljointarthroplastyarandomizedcontrolledtrial AT wanghaoyang prophylacticdoxazosinreducesurinaryretentionandpromotesrecoveryaftertotaljointarthroplastyarandomizedcontrolledtrial AT zhouzongke prophylacticdoxazosinreducesurinaryretentionandpromotesrecoveryaftertotaljointarthroplastyarandomizedcontrolledtrial |