Catheter related bladder discomfort comparison of ketamine and tolterodine; for reduction of catheter related bladder discomfort

ABSTRACT

Bladder discomfort is a common side effect after surgical procedures that involve either extensive bladder dissection or prolonged postoperative catheter drainage. Various treatments have been tried with varying degrees of success for managing this adverse effect. In this study we compared the efficacy of ketamine and tolterodine in prevention of catheter induced bladder discomfort. Three hundred patients who were scheduled for open prostatectomy or transurethral resection of prostate [TURP] were randomized into three groups. The first group received placebo, the second one received tolterodine before operation, and the third group received ketamine 250 ig/kg IV, just before the anesthesia induction. Bladder discomfort was assessed by anesthesiologist who was unaware of the type of medication. The assessment was done on arrival in the post anesthesia care unit [PACU] and then at 0, 1, 2 and 6 hours after patient's consciousness. Severity of discomfort was recorded as none, mild, moderate, or severe. The absence or presence of adverse effects were recorded. The data were analyzed using SPSS and Pearson chi-squared and ANOVA tests were applied for further statistical evaluations. Both the incidence rate of bladder discomfort and its severity in the control group was significantly higher compared with ketamine and tolterodine groups [P<0.001]. Comparing the ketamine and tolterodine groups, tolterodine had lead to lesser degree of bladder discomfort at 0, 1, 2 hours, while ketamine was more effective at 6 hours. Pretreatment with either ketamine or tolterodine is effective in decreasing the incidence and severity of catheter related bladder discomfort in patients under going open prostatectomy or TURP