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. 2022 Jan 17;11(2):454.
doi: 10.3390/jcm11020454.

Naloxegol and Postoperative Urinary Retention: A Randomized Trial

Alparslan Turan  1   2 , Jonathan Fang  1 , Wael Ali Sakr Esa  1   2 , Hassan Hamadnalla  1   3 , Steve Leung  1 , Xuan Pu  1   4 , Syed Raza  1 , David Chelnick  1 , Loran Mounir Soliman  2 , John Seif  2 , Kurt Ruetzler  1   2 , Daniel I Sessler  1
Affiliations

Naloxegol and Postoperative Urinary Retention: A Randomized Trial

Alparslan Turan et al. J Clin Med. .

Abstract

Background: Naloxegol antagonizes peripheral opioid-related side effects without preventing opioid-related analgesia. However, the effect of naloxegol on opioid-induced bladder dysfunction remains unknown.

Hypothesis: patients given naloxegol have lower residual bladder urine volume than those given placebo.

Methods: 136 patients scheduled for elective hip and knee surgery were randomized to oral naloxegol or placebo given the morning of surgery, and on the first two postoperative mornings. Residual urine volume was measured ultrasonographically within 30 min after voiding once in the morning and once in the afternoon for two postoperative days. Opioid-related Symptom Distress Scale (ORSDS), the need for indwelling urinary catheterization, and quality of recovery (QoR) score were secondary outcomes.

Results: 67 were randomized to naloxegol and 64 to placebo. We did not identify a significant effect on urine residual volume, with an estimated ratio of geometric means of 0.9 (0.3, 2.6), p = 0.84. There were no significant differences in ORSDS or QoR. There were 19 (29%) patients assigned to naloxegol who needed indwelling urination catheterization versus 7 (11%) patients in the placebo group, p = 0.012.

Conclusions: Our results do not support use of naloxegol for postoperative urinary retention after hip and knee surgery.

Keywords: anesthesia; naloxegol; residual bladder urine volume; urinary retention.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Flowchart of screening, randomization and withdrawal of patients.
Figure 2
Figure 2
Boxplot of urine residual by time. The line in the box represents the median of each group. The blue circle in the box represents the mean of urine residual in naloxegol group and blue circles outside the box represent the outliers. The red “+” sign in the box represent the mean of urine residual in placebo group and red “+” sign outside of box represent outliers.
Figure 3
Figure 3
Forest plot of primary and secondary outcome, Naloxegol versus placebo. ORDS: Opioid–Related Symptom Distress Scale. QoR-15 score: Development and Psychometric Evaluation of a Postoperative Quality of Recovery Score.
See this image and copyright information in PMC

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