Comparative Efficacy of Different Hydromorphone Doses for the Prevention of Catheter-Related Bladder Discomfort in Elderly Men

Background: The high incidence of postoperative catheter-related bladder discomfort (CRBD) in elderly male patients is associated with intraoperative urinary catheterization. In this study, we aimed to investigate the efficacy of perioperative intravenous hydromorphone administration in alleviating postoperative CRBD. Methods: This prospective study enrolled 220 elderly male individuals receiving ureteroscopic lithotripsy and randomly assigned them into four groups with 55 cases in each group. The L group was given intravenous hydromorphone at a dosage of 6 μg/kg, the N group received intravenous hydromorphone at a dosage of 10 μg/kg, the K group received intravenous (0.2 mg/kg) esketamine, and the C group received an equivalent volume of normal saline intravenously. Postoperative severity of CRBD was evaluated. The duration of anesthesia, surgical duration, alert time, extubation time, blood pressure, heart rate, pulse oxygen saturation, and MMSE scores were also evaluated. Results: Significantly lower postoperative CRBD severity was observed in the N, L, and K groups than in the C group at 2, 4, and 24 hours after surgery (p < 0.001). Furthermore, the N group had lower pain severity, compared to the L group, at 2, 4 and 24 hours postoperatively (p < 0.05). Moreover, the N group, compared to the K group, had lower pain severity at 2 and 24 hours postoperatively (p < 0.05). Notably, there were no significant differences in the other assessed outcome parameters (p > 0.05). Conclusions: Administration of intravenous hydromorphone during surgery can mitigate the postoperative severity of CRBD, and the standard anesthetic dose of 10 μg/kg hydromorphone used in this research may represent the optimal regimen. Clinical Trial Registration: Chinese Clinical Trial Registry (ChiCTR2500112701).