Effects of Intraoperative Magnesium and Ketorolac on Catheter-Related Bladder Discomfort after Transurethral Bladder Tumor Resection: A Prospective Randomized Study.

Transurethral resection of bladder tumor (TURBT) is a standard treatment for non-muscle invasive bladder cancer. However, catheter-related bladder discomfort (CRBD) often occurs due to bladder irritation caused by indwelling large-diameter urinary catheters and delays patient recovery. We investigated the efficacy of the intraoperative administration of magnesium and ketorolac in preventing early CRBD after TURBT. One hundred patients scheduled for TURBT were enrolled in this prospective, randomized, double-blind study from December 2021 to June 2022. During surgery, the experimental group ( n = 48) received intravenous magnesium and ketorolac, and the control group ( n = 50) received only intravenous ketorolac. The primary outcome was CRBD incidence immediately after surgery. CRBD severity and the postoperative recovery profiles were also evaluated. Compared to the control group, the experimental group had significantly less CRBD until 1 h after surgery (0 h: 31.3% vs. 52.0%, p = 0.037; 1 h: 54.2% vs. 74.0%, p = 0.041). However, the two groups did not differ in other postoperative findings, including CRBD severity. Co-administration of magnesium and ketorolac during surgery significantly decreased the incidence of early CRBD after TURBT compared to the single use of ketorolac.