Ultrasound-Guided Ilioinguinal/Iliohypogastric Block Mitigates Catheter-Related Bladder Discomfort After Prostate Surgery: A Prospective Randomized Controlled Trial.

Background Catheter-related bladder discomfort (CRBD) is a common and distressing complication of transurethral resection of the prostate (TURP), especially in elderly patients. However, effective prevention strategies are lacking. This study aimed to evaluate the efficacy of ultrasound-guided iliohypogastric-ilioinguinal nerve block (IINB) in alleviating CRBD. Methods Eighty elderly male patients who underwent TURP were randomly assigned to the IINB group (n = 40), which received bilateral iliosubcostal-ilioinguinal nerve blocks after general anesthesia with 15 ml of 0.33% ropivacaine on each side, or the control group (n=40), which received only standard general anesthesia. The primary outcome was the severity of CRBD (rated on a 0-3 scale) at 5 min, 1 h, 3 h, 6 h, 12 h, and 24 h postoperatively. Secondary outcomes included postoperative pain visual analog scale (VAS) scores, intraoperative opioid consumption, post-anesthesia care unit (PACU) stay duration, and other postoperative complications. Results This study evaluated the impact of nerve block (Group N) versus control (Group C) on CRBD, pain scores, opioid consumption, and recovery parameters in patients undergoing TURP. Group N exhibited significantly lower CRBD scores at 5 min (p<0.001), 1 h (p<0.001), 3 h (p<0.001), and 6 h (p<0.05) postoperatively, with no differences at 12 h or 24 h. Similarly, VAS pain scores were reduced in Group N at all early timepoints (5 min to 6 h; p<0.05 to p<0.001), aligning with the CRBD findings. Intraoperatively, Group N required less sufentanil (26.25 ± 5.63 μg vs. 32.88 ± 6.29 μg; p<0.001) and remifentanil (170.45 ± 53.63 μg vs. 217.88 ± 67.79 μg; p=0.001), and demonstrated a shorter extubation time (6.83 ± 1.75 min vs. 8.13 ± 1.49 min; p=0.001). PACU stay duration did not differ significantly (p=0.309). The incidence of postoperative complications, including postoperative nausea and vomiting (PONV), chills, hypoxemia, and sinus bradycardia, showed no statistically significant differences between groups (all p>0.05), as analyzed by Fisher's exact test.