{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T17:40:38Z","timestamp":1782322838996,"version":"3.54.5"},"reference-count":49,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T00:00:00Z","timestamp":1559088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Urinary catheterization can cause catheter-related bladder discomfort (CRBD). Ketorolac is widely used for pain control. Therefore, we evaluated the effect of ketorolac on the prevention of CRBD in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP). All patients were randomly allocated to the ketorolac group or the control group. The primary outcome was CRBD above a moderate grade at 0 h postoperatively. CRBD above a moderate grade at 1, 2, and 6 h was also assessed. Postoperative pain, opioid requirement, ketorolac-related complications, patient satisfaction, and hospitalization duration were also assessed. The incidence of CRBD above a moderate grade at 0 h postoperatively was significantly lower in the ketorolac group (21.5% vs. 50.8%, p = 0.001) as were those at 1, 2, and 6 h. Pain scores at 0 and 1 h and opioid requirement over 24 h were significantly lower in the ketorolac group, while patient satisfaction scores were significantly higher in the ketorolac group. Ketorolac-related complications and hospitalization duration were not significantly different between the two groups. This study shows ketorolac can reduce postoperative CRBD above a moderate grade and increase patient satisfaction in patients undergoing RALP, suggesting it is a useful option to prevent postoperative CRBD.<\/jats:p>","DOI":"10.3390\/jcm8060759","type":"journal-article","created":{"date-parts":[[2019,5,29]],"date-time":"2019-05-29T11:31:28Z","timestamp":1559129488000},"page":"759","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Effect of Ketorolac on the Prevention of Postoperative Catheter-Related Bladder Discomfort in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy: A Randomized, Double-Blinded, Placebo-Controlled Study"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4476-4945","authenticated-orcid":false,"given":"Jun-Young","family":"Park","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Hyuk","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihion","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doo-Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gi-Ho","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju 61453, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-A","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jai-Hyun","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Gyeong","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07247, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1982-3053","authenticated-orcid":false,"given":"Young-Kug","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e4859","DOI":"10.1097\/MD.0000000000004859","article-title":"Strategies for the prevention of catheter-related bladder discomfort: A PRISMA-compliant systematic review and meta-analysis of randomized controlled trials","volume":"95","author":"Hu","year":"2016","journal-title":"Medicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1093\/bja\/aet249","article-title":"Efficacy of butylscopolamine for the treatment of catheter-related bladder discomfort: A prospective, randomized, placebo-controlled, double-blind study","volume":"111","author":"Ryu","year":"2013","journal-title":"Br. J. Anaesth."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1089\/end.2014.0670","article-title":"Management of catheter-related bladder discomfort in patients who underwent elective surgery","volume":"29","author":"Bai","year":"2015","journal-title":"J. Endourol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1093\/bja\/ael003","article-title":"Comparison of efficacy of oxybutynin and tolterodine for prevention of catheter related bladder discomfort: A prospective, randomized, placebo-controlled, double-blind study","volume":"96","author":"Agarwal","year":"2006","journal-title":"Br. J. Anaesth."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"422","DOI":"10.7326\/M17-2640","article-title":"Diagnosis, evaluation, prevention, and treatment of chronic kidney disease\u2013mineral and bone disorder: Synopsis of the kidney disease: Improving global outcomes 2017 clinical practice guideline update","volume":"168","author":"Ketteler","year":"2018","journal-title":"Ann. Intern. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1097\/EJA.0000000000000196","article-title":"The effect of intraoperative dexmedetomidine on postoperative catheter-related bladder discomfort in patients undergoing transurethral bladder tumour resection: A double-blind randomised study","volume":"32","author":"Kim","year":"2015","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"8932","DOI":"10.1097\/MD.0000000000008932","article-title":"Efficacy of pudendal nerve block for alleviation of catheter-related bladder discomfort in male patients undergoing lower urinary tract surgeries: A randomized, controlled, double-blind trial","volume":"96","author":"Li","year":"2017","journal-title":"Medicine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1007\/s11596-014-1315-z","article-title":"Predictors of catheter-related bladder discomfort after urological surgery","volume":"34","author":"Li","year":"2014","journal-title":"J. Huazhong Univ. Sci. Technol. Med. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"American Society of Anesthesiologists Task Force on Acute Pain Management (2012). Practice guidelines for acute pain management in the perioperative setting: An updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology, 116, 248\u2013273.","DOI":"10.1097\/ALN.0b013e31823c1030"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1016\/j.jpain.2017.05.006","article-title":"Postoperative Pain Management in Spanish Hospitals: A Cohort Study Using the PAIN-OUT Registry","volume":"18","author":"Fabregas","year":"2017","journal-title":"J. Pain Off. J. Am. Pain Soc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"484","DOI":"10.4103\/1119-3077.196036","article-title":"Role of tolterodine in the management of postoperative catheter-related bladder discomfort: Findings in a Nigerian teaching hospital","volume":"20","author":"Tijani","year":"2017","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1093\/bja\/aem232","article-title":"Sublingual oxybutynin reduces postoperative pain related to indwelling bladder catheter after radical retropubic prostatectomy","volume":"99","author":"Sesay","year":"2007","journal-title":"Br. J. Anaesth."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/j.surg.2014.05.017","article-title":"Randomized, clinical trial on the preventive effects of butylscopolamine on early postoperative catheter-related bladder discomfort","volume":"157","author":"Nam","year":"2015","journal-title":"Surgery"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1111\/papr.12055","article-title":"Effects of Intra-Operative Ketamine Administration on Postoperative Catheter-Related Bladder Discomfort: A Double-Blind Clinical Trial","volume":"14","author":"Lajevardi","year":"2014","journal-title":"Pain Pract."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1007\/s00540-015-2064-2","article-title":"Effect of glycopyrrolate versus atropine coadministered with neostigmine for reversal of rocuronium on postoperative catheter-related bladder discomfort in patients undergoing transurethral resection of bladder tumor: A prospective randomized study","volume":"29","author":"Kim","year":"2015","journal-title":"J. Anesth."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1161\/ATVBAHA.110.207449","article-title":"Prostaglandins and inflammation","volume":"31","author":"Ricciotti","year":"2011","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1093\/bja\/88.2.227","article-title":"Ketorolac, diclofenac, and ketoprofen are equally safe for pain relief after major surgery","volume":"88","author":"Forrest","year":"2002","journal-title":"Br. J. Anaesth."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1111\/papr.12198","article-title":"Ketorolac Tromethamine\u2014Routes and Clinical Implications","volume":"15","author":"Vadivelu","year":"2015","journal-title":"Pain Pract."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1001\/jamasurg.2017.0898","article-title":"Postoperative Multimodal Analgesia Pain Management with Nonopioid Analgesics and Techniques: A Review","volume":"152","author":"Wick","year":"2017","journal-title":"JAMA Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1001\/jama.280.11.969","article-title":"Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer","volume":"280","author":"Whittington","year":"1998","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1093\/bja\/aen217","article-title":"Evaluation of intra-operative tramadol for prevention of catheter-related bladder discomfort: A prospective, randomized, double-blind study","volume":"101","author":"Agarwal","year":"2008","journal-title":"Br. J. Anaesth."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1002\/1097-0215(20001220)90:6<305::AID-IJC1>3.0.CO;2-U","article-title":"Patterns of prostate cancer biopsy grading: Trends and clinical implications","volume":"90","author":"King","year":"2000","journal-title":"Int. J. Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.1001\/jama.1997.03540420041027","article-title":"Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer: A multi-institutional update","volume":"277","author":"Partin","year":"1997","journal-title":"JAMA"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/j.eururo.2015.06.046","article-title":"A contemporary prostate cancer grading system: A validated alternative to the Gleason score","volume":"69","author":"Epstein","year":"2016","journal-title":"Eur. Urol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1097\/01.pas.0000173646.99337.b1","article-title":"The 2005 International Society of Urological Pathology (ISUP) Consensus Conference on Gleason Grading of Prostatic Carcinoma","volume":"29","author":"Epstein","year":"2005","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1016\/j.eururo.2017.12.018","article-title":"Updates in the Eighth Edition of the Tumor-Node-Metastasis Staging Classification for Urologic Cancers","volume":"73","author":"Paner","year":"2018","journal-title":"Eur. Urol."},{"key":"ref_27","unstructured":"Edge, S.B., Byrd, D.R., Compton, C.C., Fritz, A.G., Greene, F.L., and Trotti, A. (2010). JCC Cancer Staging Manual, Springer. [7th ed.]."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1093\/bja\/65.4.448","article-title":"Comparison of i.m. ketorolac trometamol and morphine sulphate for pain relief after cholecystectomy","volume":"65","author":"Power","year":"1990","journal-title":"Br. J. Anaesth."},{"key":"ref_29","unstructured":"McPherson, M.L. (2009). Demystifying Opioid Conversion Calculations: A Guide for Effective Dosing, ASHP."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"151","DOI":"10.4103\/2348-8093.169965","article-title":"Measuring pain in clinical trials: Pain scales, endpoints, and challenges","volume":"2","author":"Bhardwaj","year":"2015","journal-title":"Int. J. Clin. Exp. Physiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1001\/jama.282.20.1929","article-title":"Adverse upper gastrointestinal effects of rofecoxib compared with NSAIDs","volume":"282","author":"Langman","year":"1999","journal-title":"JAMA"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.jclinane.2013.04.018","article-title":"Predictors of desaturation in the postoperative anesthesia care unit: An observational study","volume":"25","author":"Siddiqui","year":"2013","journal-title":"J. Clin. Anesth."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1093\/bja\/ael094","article-title":"Emergence delirium in adults in the post-anaesthesia care unit","volume":"96","author":"Lepouse","year":"2006","journal-title":"Br. J. Anaesth."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1111\/aas.12922","article-title":"Sevoflurane vs. propofol in post-operative catheter-related bladder discomfort: A prospective randomized study","volume":"61","author":"Kim","year":"2017","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1007\/s12630-016-0600-7","article-title":"The effect of sevoflurane versus desflurane on postoperative catheter-related bladder discomfort in patients undergoing transurethral excision of a bladder tumour: A randomized controlled trial","volume":"63","author":"Kim","year":"2016","journal-title":"Can. J. Anaesth."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1213\/01.ane.0000281154.03887.2b","article-title":"An evaluation of the efficacy of gabapentin for prevention of catheter-related bladder discomfort: A prospective, randomized, placebo-controlled, double-blind study","volume":"105","author":"Agarwal","year":"2007","journal-title":"Anesth. Analg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/S1098-3597(01)90069-9","article-title":"Understanding NSAIDs: From aspirin to COX-2","volume":"3","author":"Green","year":"2001","journal-title":"Clin. Cornerstone"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/S0022-5347(17)44109-7","article-title":"Urinary bladder prostanoids\u2014Their synthesis, function and possible role in the pathogenesis and treatment of disease","volume":"137","author":"Mikhailidis","year":"1987","journal-title":"J. Urol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S0094-0143(21)00501-2","article-title":"Anatomy and physiology of the lower urinary tract","volume":"20","year":"1993","journal-title":"Urol. Clin. N. Am."},{"key":"ref_40","first-page":"425","article-title":"Evidence for the involvement of a capsaicin-sensitive innervation in the afferent branch of micturition reflex in rats","volume":"69","author":"Maggi","year":"1987","journal-title":"Acta Physiol. Hung."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/0014-2999(88)90221-X","article-title":"Prostanoids modulate reflex micturition by acting through capsaicin-sensitive afferents","volume":"145","author":"Maggi","year":"1988","journal-title":"Eur. J. Pharmacol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.curtheres.2012.08.001","article-title":"Effect of intraoperative paracetamol on catheter-related bladder discomfort: A prospective, randomized, double-blind study","volume":"73","author":"Ergenoglu","year":"2012","journal-title":"Curr. Ther. Res. Clin. Exp."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1002\/hep.20293","article-title":"Acetaminophen and the US Acute Liver Failure Study Group: Lowering the risks of hepatic failure","volume":"40","author":"Lee","year":"2004","journal-title":"Hepatology"},{"key":"ref_44","first-page":"11","article-title":"Paracetamol: Mechanism of action, applications and safety concern","volume":"71","author":"Nowak","year":"2014","journal-title":"Acta Pol. Pharm."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"c6764","DOI":"10.1136\/bmj.c6764","article-title":"Acute liver failure after administration of paracetamol at the maximum recommended daily dose in adults","volume":"341","author":"Claridge","year":"2010","journal-title":"BMJ"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1136\/bmj.306.6871.157","article-title":"Liver failure induced by paracetamol","volume":"306","author":"Bray","year":"1993","journal-title":"BMJ"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1136\/jcp.30.2.141","article-title":"Frequency of renal impairment in paracetamol overdose compared with other causes of acute liver damage","volume":"30","author":"Wilkinson","year":"1977","journal-title":"J. Clin. Pathol."},{"key":"ref_48","first-page":"1090","article-title":"Factors influencing ketorolac-associated perioperative renal dysfunction","volume":"86","author":"Jaquenod","year":"1998","journal-title":"Anesth. Analg."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Bjarnason, I. (2013). Gastrointestinal safety of NSAIDs and over-the-counter analgesics. Int. J. Clin. Pract. Suppl., 37\u201342.","DOI":"10.1111\/ijcp.12048"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/6\/759\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:54:30Z","timestamp":1760187270000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/6\/759"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,29]]},"references-count":49,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,6]]}},"alternative-id":["jcm8060759"],"URL":"https:\/\/doi.org\/10.3390\/jcm8060759","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,29]]}}}