Effect of an Intravenous Acetaminophen/Ibuprofen Fixed-Dose Combination on Catheter-Related Bladder Discomfort: A Prospective, Randomized, Placebo-Controlled, Double-Blind Pilot Study.

Background and

Objectives

Catheter-related bladder discomfort (CRBD) commonly arises as a direct consequence of perioperative urinary catheterization. A fixed-dose combination of 1000 mg acetaminophen and 300 mg ibuprofen provides multimodal analgesia. In this study, we assessed the impact of this fixed-dose combination on mitigating CRBD in patients undergoing urological procedures. Materials and

Methods

In this prospective pilot study, 23 patients undergoing urological surgery requiring urinary catheterization were randomized into two groups; approximately 20 min before the anticipated end of surgery, patients were administered a combination of 1000 mg acetaminophen and 300 mg ibuprofen (intervention group, n = 11) or saline (control group, n = 12). The primary endpoint was the incidence of CRBD immediately after the patient's arrival at the post-anesthetic care unit (PACU). The incidence of CRBD at 1, 2, and 6 h postoperatively and the severity of CRBD at each time point were also assessed.

Results

The incidence of CRBD immediately after arrival at the PACU was lower in the intervention group (54.5% vs. 100%, p = 0.014). However, no significant differences in overall CRBD incidence were observed at later postoperative time points. The incidence of moderate CRBD was lower in the intervention group at 0 h and 1 h (p = 0.036 and 0.037, respectively).

Conclusions

The findings of this pilot randomized trial provide preliminary evidence that intravenous acetaminophen and ibuprofen may reduce early postoperative CRBD following urological surgery. Given the small sample size and single-center design, larger multicenter randomized studies are needed to confirm these findings.