Effect of Esketamine on Catheter-Related Bladder Discomfort in Elderly Male Patients Undergoing Flexible Ureteroscopic Lithotripsy After General Anesthesia.
Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses – May 23, 2025
Source: PubMed
Summary
A lower dose of esketamine proves more effective in reducing post-surgery bladder discomfort in elderly men. In this breakthrough finding, researchers gave different doses to patients undergoing ureteroscopic lithotripsy. The 0.2mg/kg dose better reduced catheter-related bladder discomfort compared to both higher doses and placebo, while maintaining safety. This offers a promising solution for managing this common surgical complication.
Abstract
Postoperative catheter-related bladder discomfort (CRBD) is a common complication in elderly male patients after intraoperative urinary catheterization. This research seeks to investigate if the intraoperative administration of esketamine can decrease the incidence and severity of CRBD and compare the effects of esketamine dosages of 0.2 and 0.5 mg/kg. A prospective randomized controlled trial. This randomized controlled study involved 90 elderly male patients undergoing elective ureteroscopic lithotripsy. Patients were divided into three groups (n = 30 each). The low-dose group (L group) received 0.2 mg/kg esketamine intravenously before catheterization, the normal-dose group (N group) received 0.5 mg/kg esketamine, and the control group (C group) received an equivalent volume of normal saline. CRBD incidence and severity were assessed at 2, 4, 24, and 48 hours postoperatively. Secondary outcomes included extubation time, time to alertness, and physiological parameters (heart rate, blood pressure, oxygen saturation, and Mini-mental State Examination [MMSE] scores) over the same periods. The L group showed reduced CRBD incidence at 48 hours and lower CRBD severity at all time points compared to the C group (P .05). Intravenous esketamine effectively reduces the incidence and severity of postoperative CRBD in elderly male patients undergoing ureteroscopic lithotripsy. A subanesthetic dose (0.2 mg/kg) demonstrates superior efficacy compared to an anesthetic dose (0.5 mg/kg), offering a safer and more effective strategy for managing CRBD.