Meta-analysis of epidural analgesia versus parenteral opioid analgesia after colorectal surgery

Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review

“…The odds ratio for POUR after colorectal surgery and epidural analgesia was reported to be as great as 4.3 (95% CI 1.2 to 15.9). 5 Weiniger et al showed that intrapartum women receiving epidural analgesia during labour had greater post void residuals independent of fluid volume administered when compared with controls not receiving epidural anesthesia (median 240 mL vs 45 mL, respectively) with Table 4 Retention defined as bladder volume by US exceeding pre-op bladder capacity estimate and inability to void AMB = ambulatory, Diamorph = diamorphine, epi = epinephrine, Fent = fentanyl, GEN = general surgery, GYN = gynecology, hydromorph = hydromorphone; Meth = methadone, morph = morphine, n = number in group, N = number in study, N/A = not applicable or not indicated in study, OB = obstetric, OBS = observational study, ORTHO = orthopedic surgery, PCEA = patient controlled epidural analgesia, PVR = post void residual, RCT = randomized controlled trial, REV = retrospective review, Sufent = sufentanil, THOR = thoracic surgery, URO = urology, US = ultrasound no significant difference on postpartum days one or two. 102 In addition, advanced age appears to be a risk factor for urinary retention as males [ 70 yr having spinal anesthesia for lower limb joint replacement are at higher risk of developing retention than females or those \ 69 yr irrespective of anesthetic modality.…”

“…When alleviated with catheterization, urinary retention can increase morbidity by introducing infection and increasing the length of hospital stay. [2][3][4][5] Urinary retention is the inability to initiate micturition or to empty the bladder completely. There are no clear defining characteristics of urinary retention, such as a specific volume of urine or elapsed time postoperatively without micturition; however, in accordance with the consensus view in the contemporary literature, urinary retention would be described as an inability to initiate micturition with a bladder volume exceeding 500 mL.…”

Effect of bisacodyl on postoperative bowel motility in elective colorectal surgery: a prospective, randomized trial

“…Epidural analgesia carries a certain risk for adverse effects and is not feasible in all patients, for example those with spondylodesis or severe spondylarthrosis, but is currently considered as one of the most effective methods [1,40]. The number of patients receiving a mid-thoracic epidural catheter was similar between the bisacodyl and placebo groups.…”

Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations

“…No prokinetic agent has been shown to be effective in attenuating or treating postoperative ileus, but several other types of interventions have been successful. Mid-thoracic epidural analgesia [156] as compared with intravenous opioid analgesia is highly effective at preventing postoperative ileus [83,157]. Fluid overloading during [158] and after [159] surgery impairs gastrointestinal function and should be avoided.…”