Ketamine for treatment of catheter related bladder discomfort: a prospective, randomized, placebo controlled and double blind study

Abstract

Background: Intraoperative urinary catheterization might cause postoperative catheter related bladder discomfort (CRBD). We evaluated the efficacy of ketamine as a treatment modality for CRBD.

Methods: Fifty-four, ASA physical status I and II, male and female adult patients, having CRBD after elective percutaneous nephrolithotomy were randomized into two equal groups of 27 each. In the postoperative period, patients who complained of CRBD received medication depending upon group allocation. Group 1 (Control) received placebo, Group II (Ketamine) received i.v. ketamine 250 microg kg(-1). After induction of anaesthesia patients were catheterized with a 16 Fr Foley's catheter and the balloon was inflated with 10 ml distilled water. Grading of CRBD was done as none, mild, moderate and severe by a blinded observer at 0, 1, 2 and 6 h after operation.

Results: Ketamine reduced the incidence of CRBD (P<0.001) at 2 and 6 h along with reduction in severity (P<0.05) at 1 h compared with control. Higher incidence of mild sedation was observed in the ketamine group (P<0.05) which was not associated with any untoward effects. Operative time and intraoperative fentanyl requirement were similar in both the groups.

Conclusion: I.V. ketamine (250 microg kg(-1)) is an effective treatment for reducing the incidence and severity of postoperative CRBD.