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.