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Efficacy appraisal of four regimens (granisetron, ketamine, dexmedetomidine, and lidocaine combined with fentanyl) for cystoscopy-associated sedation and analgesia and catheter-related bladder tolerance: a randomized clinical trial
Hesameddin Modir1, Rasol Jafarirismani2, Amir Almasi-Hashiani3, Kiana Shamaii4
1 Departments of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak, Iran
2 Department of Urologic Surgery, Arak University of Medical Sciences, Arak, Iran
3 Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
4 Student Research Committee, Arak University of Medical Sciences, Arak, Iran
Correspondence Address:
Hesameddin Modir,
Departments of Anesthesiology and Critical Care, Arak University of Medical Sciences, Arak
Iran
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/2045-9912.345172
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The authors sought to quantify the clinical impacts of granisetron, ketamine, dexmedetomidine, and lidocaine combined with fentanyl, for procedural sedation and analgesia in cystoscopy and for bladder catheter tolerance. This double-blind trial recruited four stratified blocked randomized eligible groups of patients (n = 120) formerly identified as needing cystoscopy, each receiving one of the above four anesthetic agents. Dexmedetomidine-sedated subjects experienced less pain from 5 to 120 minutes after the beginning of procedure, and next the ketamine manifested a better pain relief experienced. Sedation score was found to be rather more satisfactory in the early-mentioned from 15 to 55 minutes and at 90 and 105 minutes after procedure. The mean opioid use was observed lower in the dexmedetomidine treated patients and next in the ketamine administered patients. Considering the findings emanating from the study and the lack of complications that need to be treated, dexmedetomidine and ketamine afforded superior pain relief, greater sedation, and less postoperative opioid use in patients undergoing cystoscopy, and thus, they could be suggested to be combined with fentanyl during outpatient cystoscopy.
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