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

Background. Intraoperative urinary catheterization might causepostoperative catheter related bladder discomfort (CRBD). Weevaluated the efficacy of ketamine as a treatment modality forCRBD. Methods. Fifty-four, ASA physical status I and II, male andfemale adult patients, having CRBD after elective percutaneousnephrolithotomy were randomized into two equal groups of 27each. In the postoperative period, patients who complained ofCRBD received medication depending upon group allocation. Group1 (Control) received placebo, Group II (Ketamine) received i.v.ketamine 250 µg kg^–1. After induction of anaesthesiapatients were catheterized with a 16 Fr Foley's catheter andthe balloon was inflated with 10 ml distilled water. Gradingof CRBD was done as none, mild, moderate and severe by a blindedobserver 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) at1 h compared with control. Higher incidence of mild sedationwas observed in the ketamine group (P<0.05) which was notassociated with any untoward effects. Operative time and intraoperativefentanyl requirement were similar in both the groups. Conclusion. I.V. ketamine (250 µg kg^–1) is an effectivetreatment for reducing the incidence and severity of postoperativeCRBD.