Comparison of the effect of acupoint injection and tramadol for the treatment of catheter-related bladder discomfort: A randomized controlled trial

Postoperative catheter-related bladder discomfort (CRBD) is a common complication of intraoperative urinary catheterization. We conducted this study to compare the effects of acupoint injection and tramadol for the treatment of postoperative CRBD after gynecological surgery. Ninety patients who underwent elective gynecological surgery with intraoperative urinary catheterization and spontaneously complained of CRBD during recovery in the post-anesthesia care unit were randomized into 3 groups of 30 each. Group A received acupoint injections (Zusanli [ST 36], Sanyinjiao [SP 6], Zhongji [CV 3], and Guanyuan [CV 4]), Group B received 1.5 mg/kg tramadol, while Group C received normal saline. The severity of CRBD was measured as none, mild, moderate, or severe; or recorded using visual analog scale score ranging from 0 (no discomfort) to 10 (most severe discomfort). These measurements were reported at 0 (immediate treatment time), 0.5, 1, 2 and 6 hours after treatment. The severity of CRBD was reduced in group A compared to that in group C at immediate treatment time, 1, 2, and 6 hours after treatment, while the severity of CRBD was reduced in group B compared to that in group C at 1 and 2 hours after treatment. The actual visual analog scale score for CRBD was also lower in groups A and B compared to that in group C after treatment. Additionally, Group A had a higher rate of effective therapy than group C at immediate treatment time, 1, 2, and 6 hours after treatment, while Group B had a higher rate of effective therapy than group C at 1 and 2 hours after treatment. Group B had a higher incidence of nausea compared to Groups A and C; however, there were no differences observed regarding vomiting, dizziness, drowsiness, or headache. Acupoint injection was superior than tramadol for treating CRBD after elective gynecological surgery. Acupoint injection could even take effect at immediate treatment time, however, tramadol take effect half an hour after administration. Moreover, tramadol increased the incidence of nausea (as high as over 30%) compared with acupoint injection.