Comparison of Tramadol and Dexmedetomidine in the Prevention of Urinary Catheter Discomfort in Urinary Surgery
Condition: Catheter Related Complication
Study type: Interventional

Summary: 
      The investigators aimed to compare the effects of tramadol and dexmedetomidine, which are
      commonly used in anesthesia, on preventing catheter-related bladder discomfort.
    

Detailed description: 
      Urinary catheterization is an attempt frequently used in many surgeries, emergency services
      or intensive care units, especially urinary surgeries to facilitate urine output or evaluate
      urine output. However, as a result of urinary catheter application, most patients may develop
      some symptoms like pain, burning sensation and the urge to urinate constantly in the
      suprapubic region that the investigators call this catheter-related bladder discomfort
      (CRBD).

      The incidence of CRBD can increase 47 to 90% in the postoperative period. The main reason of
      CRBD is involuntary contractions caused by muscarinic receptors, especially type 3 (M3)
      receptors. Therefore, antimuscarinic drugs are used to prevent and treat CRBD. Studies have
      shown that many drugs such as ketamine, tolterodine, oxybutynin, gabapentin, pregabalin,
      butylscopolamine, tramadol, dexmedetomidine are effective in preventing CRBD. Their common
      feature is antimuscarinic effects. However, no definitive conclusion could be reached for
      routine use, due to the low number of samples in the studies, surgical differences or some
      anticholinergic and sedative side effects. Additionally, oxybutynin, tolterodine, gabapentin,
      and pregabalin are only preoperatively administered orally. So more research is needed to
      find the ideal agent to prevent CRBD.

      Tramadol is frequently used for moderate pain in surgeries. It is a centrally acting
      synthetic opioid analgesic that has an inhibitory effect on M1 and M3 muscarinic receptors.
      Tramadol has proven to be effective in reducing the severity and frequency of ICBR in
      intraoperative use. However, like other opioids, it can have side effects such as
      nausea-vomiting and sedation.

      Dexmedetomidine is a selective alpha-2 adrenoceptor agonist that has analgesic, sympatholytic
      and sedative properties. In recent studies, it has been reported that dexmedetomidine is
      associated with the pathophysiology of CRBD by inhibiting type-3 (M3) muscarinic receptor
      which has beneficial effects in preventing CRBD in intraoperative use. Dexmedetomidine
      decreases the frequency of CRBD by 30%.

      The first purpose of the study is to compare the effects of dexmedetomidine and tramadol on
      CRBD. Secondarily, the investigators aimed to compare them for their side effects.
    

Intervention name(s): Tramadol; Dexmedetomidine; control
Intervention type(s): Drug; Drug; Other
Intervention description(s): tramadol and paracetamol will perform; dexmedetomidine and paracetamol will perform; paracetamol will perform
Other intervention name(s): Contramal; precedex
Intervention MeSH terms: Dexmedetomidine; Tramadol
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: dexmedetomidine; tramadol; catheter-related bladder discomfort