Bala, I., Bharti, N., Chaubey, V.K., & Mandal, A.K. (2012). Efficacy of gabapentin for prevention of postoperative catheter-related bladder discomfort in patients undergoing transurethral resection of bladder tumor. Urology, 79, 853–857.

To evaluate the effect of 600 mg and 1200 mg oral gabapentin pretreatment for the prevention of postoperative catheter-related bladder discomfort (CRBD) in patients undergoing catheterization after transurethral resection of bladder tumor (TURBT)

Patients were randomized to three groups. Group I received four placebo capsules. Group II received two capsules of 300 mg gabapentin and two identical placebo capsules. Group III received four capsules of 300 mg gabapentin. All patients received the study drug orally, with sips of water, one hour prior to administration of anesthesia. Lumbar subarachnoid block was administered with 2.5 ml 0.5% hyperbaric bupivacaine. An anesthesiologist unaware of group assignment observed patients in the Postanesthesia Care Unit (PACU) at 1, 2, 4, 6, 12, and 24 hours.

• The sample was composed of 100 patients.
• Mean patient age was 52.2 years.
• Of all patients, 79% were male and 21% were female.
• All patients had been diagnosed with a bladder tumor.

• Single site
• Inpatient
• United States

Active antitumor treatment

Randomized controlled double-blind trial

• Four-point scale, to record severity of bladder discomfort
• Observations of postoperative nausea, vomiting, and any adverse effect (e.g., sedation, dizziness, ataxia, tinnitus, diplopia, vertigo) related to the study drug

• At 1, 2, and 24 hours after surgery, patients in group II, who received 600 mg gabapentin, had significantly lower incidence of CRBD (p < 0.0001) than did patients in the control group (group I).
• At all time points, the incidence of CRBD was significantly lower (p < 0.0001) in patients receiving 1200 mg gabapentin (group III) than in the control group (group I).
• At 4, 6, 12, and 24 hours, the incidence of CRBD was significantly lower (p < 0.0001) in patients receiving 1200 mg gabapentin (group III) than in group II.
• Compared to the severity of CRBD in group I, the severity of CRBD was significantly lower (p < 0.0001) in groups II and III.

Pretreatment with gabapentin reduces bladder discomfort in patients with an indwelling postoperative catheter. Gabapentin 1200 mg is more effective than gabapentin 600 mg in decreasing the incidence and severity of CRBD.

• The study had risk of bias due to sample characteristics. The sample was primarily male, though the male-to-female ratio was similar in all three groups.
• Findings are not generalizable.

To decrease the postoperative discomfort of patients undergoing catheterization after transurethral resection of bladder tumor, nurses may want to advocate for the preoperative use of 1200 mg gabapentin.