Objectives: We conducted meta-analysis to demonstrate the efficacy and safety of ketamine on postoperative catheter-related bladder discomfort (CRBD).

Methods: A systematic search was performed through PubMed, Embase, and Cochrane Library to identify all randomized controlled trials that used ketamine in postoperative CRBD. This study was carried out by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We used RevMan version 5.3.0. to analyze the data.

Results: Five RCTs involving 414 patients were included in the analysis. The incidence and severity of postoperative CRBD were assessed at 0, 1, 2, and 6 h. According to our results of meta-analysis, ketamine reduced the incidence of postoperative CRBD at 2 h (RR 0.39; 95% CI, 0.21–0.71; p = 0.002, I² = 40%) and 6 h (RR 0.29; 95% CI, 0.16–0.50; p < 0.0001, I² = 0%) significantly; however, there were no statistical differences at 0 h (RR 0.81; 95% CI, 0.35–1.88; p = 0.62, I² = 96%) and 1 h (RR 0.57; 95% CI, 0.13–2.54; p = 0.46, I² = 97%). In two studies, we compared the incidence of moderate-to-severe CRBD between groups according to the scaling system (none, mild, moderate, and severe), and data are presented as numbers. Patients in the ketamine group showed a significantly lower severity of CRBD than those in the placebo group at 1 h (RR 0.09; 95% CI, 0.03–0.31; p = 0.0001) and 2 h (RR 0.06; 95% CI, 0.01–0.44; p = 0.005). In contrast, there were no meaningful differences between the two groups in the severity of CRBD at 0 h (RR 0.18; p = 0.84) or 6 h (RR 0.20; 95% CI, 0.03–1.59; p = 0.13). There were no meaningful differences on the rate of adverse events between the ketamine group and control group, mainly including postoperative nausea and vomiting (RR 1.24; 95% CI, 0.89–1.72; p = 0.21), diplopia (RR 3.00; 95% CI, 0.48–18.67; p = 0.24), and hallucination (RR 3.00; 95% CI, 0.32–28.24; p = 0.34).

Conclusion: Our meta-analysis demonstrated that a sub-hypnotic dose of ketamine administration can reduce the incidence and severity of postoperative CRBD without causing evident side effects.

目标：我们进行了荟萃分析，以证明氯胺酮对术后导管相关膀胱不适 (CRBD) 的疗效和安全性。

方法：通过 PubMed、Embase 和 Cochrane 图书馆进行了系统搜索，以确定所有在术后 CRBD 中使用氯胺酮的随机对照试验。这项研究是通过使用系统评价和元分析的首选报告项目进行的。我们使用 RevMan 5.3.0 版。分析数据。

结果：五项随机对照试验涉及 414 名患者，被纳入分析。在 0、1、2 和 6 小时评估术后 CRBD 的发生率和严重程度。根据我们的荟萃分析结果，氯胺酮可降低术后 2 小时 CRBD 的发生率（RR 0.39；95% CI，0.21-0.71；p= 0.002，I ² = 40%）和 6 小时（RR 0.29；95% CI，0.16–0.50；p< 0.0001, I ² = 0%) 显着；然而，在 0 小时没有统计学差异（RR 0.81；95% CI，0.35–1.88；p= 0.62，I ² = 96%）和 1 小时（RR 0.57；95% CI，0.13–2.54；p= 0.46，I ² = 97%）。在两项研究中，我们根据标度系统（无、轻度、中度和重度）比较了组间中度至重度 CRBD 的发生率，数据以数字表示。氯胺酮组患者在 1 小时时的 CRBD 严重程度显着低于安慰剂组（RR 0.09；95% CI，0.03-0.31；p= 0.0001) 和 2 小时 (RR 0.06; 95% CI, 0.01–0.44;p= 0.005)。相比之下，两组在 0 h 时 CRBD 的严重程度没有显着差异（RR 0.18；p= 0.84) 或 6 小时 (RR 0.20; 95% CI, 0.03–1.59;p= 0.13)。氯胺酮组和对照组的不良事件发生率无显着差异，主要包括术后恶心和呕吐（RR 1.24；95% CI，0.89-1.72；p= 0.21），复视（RR 3.00；95% CI，0.48–18.67；p= 0.24）和幻觉（RR 3.00；95% CI，0.32–28.24；p= 0.34)。

结论：我们的荟萃分析表明，亚催眠剂量的氯胺酮给药可以降低术后 CRBD 的发生率和严重程度，而不会引起明显的副作用。