{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:17:08Z","timestamp":1791343028105,"version":"4.3.1"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"vor","delay-in-days":1383,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:p>\n          Background: Catheter-related bladder discomfort (CRBD) is one of the main reasons of agitation after surgery, leading to urgency and frequency during recovery. Ketamine has been used as an effective drug for reducing the signs and severity of this problem. We hypothesized that intraurethral instillation of ketamine\u2013lidocaine gel before urinary catheterization can reduce the incidence of CRBD in the postoperative period. Materials and Methods: A total of 136 male patients, who underwent two-level laminectomy\/discectomy were enrolled in this randomized clinical trial. Patients were randomized into the two groups before urinary catheterization. The ketamine group received urethral lubrication with 5 mL xylocaine jelly (2%) in conjunction with 2 mL (100 mg) ketamine. Patients in control group received urethral lubrication with 5 mL xylocaine jelly (2%) in conjunction with 2 mL distilled water. The primary outcome was the incidence of CRBD. CRBD was assessed using four-stage criteria when arriving in the recovery room and at 1, 2, and 6 h after surgery. Postsurgical pain and the number of sedatives given and opioid requirement were also the secondary outcomes in this study. Results: Intraurethral instillation of ketamine\u2013lidocaine gel reduced the incidence of CRBD at recovery (P &lt; 0.001) along with a reduction in the severity of CRBD (P &lt; 0.05) during the 1st and 2nd visit compared with control group. The mean pain intensity score (visual analog scale) and opioid requirement to relieve postsurgical pain were lower in the ketamine group during all the study timepoints from recovery and after transfer to the ward (P &lt; 0.008). A higher rate of sedation (72% vs. 11%) also was seen at recovery period in the ketamine group (P &lt; 0.008). Conclusion: Intraurethral instillation of ketamine\u2013lidocaine gel before bladder catheterization is an effective technique for reducing the incidence and severity of postoperative CRBD.<\/jats:p>","DOI":"10.4103\/ajns.ajns_314_17","type":"journal-article","created":{"date-parts":[[2018,4,25]],"date-time":"2018-04-25T12:01:21Z","timestamp":1524657681000},"page":"1057-1060","source":"Crossref","is-referenced-by-count":3,"title":["Preemptive Effect of Intraurethral Instillation of Ketamine\u2013lidocaine Gel on Postoperative Catheter-related Bladder Discomfort after Lumbar Spine Surgery"],"prefix":"10.1055","volume":"13","author":[{"given":"Farhad","family":"Etezadi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and critical care, Sina Hospital, Tehran University of Medical Sciences, Tehran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasamin","family":"Sajedi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Khajavi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and critical care, Sina Hospital, Tehran University of Medical Sciences, Tehran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Moharari","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and critical care, Sina Hospital, Tehran University of Medical Sciences, Tehran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abbas","family":"Amirjamshidi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"key-10.4103\/1793-5482.231059-1","first-page":"122","volume-title":"Predictors of catheter-related bladder discomfort in the post-anaesthesia care unit","author":"Binhas","year":"2011","journal-title":"Ann Fr Anesth Reanim"},{"key":"key-10.4103\/1793-5482.231059-2","first-page":"596","volume-title":"The effect of intraoperative dexmedetomidine on postoperative catheter-related bladder discomfort in patients undergoing transurethral bladder tumour resection: A double-blind randomised study","author":"Kim","year":"2015","journal-title":"Eur J Anaesthesiol"},{"key":"key-10.4103\/1793-5482.231059-3","first-page":"720","volume-title":"Ketamine for treatment of catheter-related bladder discomfort","author":"Gupta","year":"2005","journal-title":"Br J Anaesth"},{"key":"key-10.4103\/1793-5482.231059-4","first-page":"1454","volume-title":"An 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volunteers","author":"Olofsen","year":"2012","journal-title":"Anesthesiology"},{"key":"key-10.4103\/1793-5482.231059-12","first-page":"57","volume-title":"Inhibition by ketamine of muscarinic acetylcholine receptor function","author":"Durieux","year":"1995","journal-title":"Anesth Analg"},{"key":"key-10.4103\/1793-5482.231059-13","first-page":"587","volume-title":"Ketamine for treatment of catheter related bladder discomfort: A prospective, randomized, placebo controlled and double blind study","author":"Agarwal","year":"2006","journal-title":"Br J Anaesth"},{"key":"key-10.4103\/1793-5482.231059-14","first-page":"146","volume-title":"Effects of intra-operative ketamine administration on postoperative catheter-related bladder discomfort: A double-blind clinical trial","author":"Shariat","year":"2014","journal-title":"Pain Pract"},{"key":"key-10.4103\/1793-5482.231059-15","first-page":"e37778","volume-title":"Combined ketamine-tramadol subcutaneous wound infiltration for multimodal postoperative analgesia: A double-blinded, randomized controlled trial after renal surgery","author":"Khajavi","year":"2016","journal-title":"Anesth Pain Med"},{"key":"key-10.4103\/1793-5482.231059-16","first-page":"149","volume-title":"Intraperitoneal ketamine attenuates the inflammatory reactivity associated with pneumoperitoneum","author":"El-Gaby","year":"2017","journal-title":"Res Opinion Anesth Intensive Care"},{"key":"key-10.4103\/1793-5482.231059-17","first-page":"478","volume-title":"Preemptive analgesia with Ketamine for Laparoscopic cholecystectomy.J Anaesthesiol Clin Pharmacol","author":"Singh","year":"2013","journal-title":""}],"container-title":["Asian Journal of 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