Patient-controlled epidural analgesia: the role of epidural fentanyl in peripartum urinary retention

Evron, Shmuel; Muzikant, Gleb; Rigini, Nugzar; Khazin, Vadim; Sessler, D. I.; Sadan, Oscar; Ezri, Tiberiu

doi:10.1016/j.ijoa.2005.10.019

Cited by 11 publications

(8 citation statements)

References 26 publications

(36 reference statements)

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“…27,58,61,63 Urinary tract infection Thirteen of the 94 studies included in this review reported the incidence of urinary tract infection associated with catheterization. 28,30,40,61,63,64,66,69,73,75,76,89,100 Six of these reported no infections while seven studies reported rates of \ 10%.…”

Section: Comparison With Other Anesthetic Modalitiesmentioning

confidence: 99%

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

Choi

Mahon

Awad

2012

Can J Anesth/J Can Anesth

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Purpose Urinary retention requiring catheterization carries the risk of infection. Neuraxial anesthesia causes transient impairment of bladder function ranging from delayed initiation of micturition to frank urinary retention. We undertook a review of the literature to determine the elements of neuraxial anesthesia and analgesia that prolong bladder dysfunction and increase the incidence of urinary retention. Methods We performed a systematic search of the PubMed, MEDLINE, and EMBASE databases (from January 1980 to January 2011) to identify studies where neuraxial anesthesia and/or analgesia were employed and at least one of the following outcomes was reported: urinary retention, time to micturition, or post void residual. We included randomized controlled trials and observational studies published in the English language and we excluded case reports. The randomized trials were graded according to the Jadad score. Principal findings Our search yielded 94 studies, and in 16 of these studies, the authors reported time to micturition after intrathecal anesthesia of varying local anesthetics and doses. Intrathecal injections were performed in 41 of these studies, epidural anesthesia/analgesia was used in 39 studies, and five studies involved both the intrathecal and epidural routes. Meta-analysis was not possible because of the heterogeneity of interventions and reported outcomes. The duration of detrusor dysfunction after intrathecal anesthesia is correlated with local anesthetic dose and potency. The incidence of urinary retention displays a similar trend and is further increased by the presence of neuraxial opioids, particularly long-acting variants. Urinary tract infection secondary to catheterization occurred rarely. Conclusions Neuraxial anesthesia/analgesia results in transient detrusor dysfunction. The duration of dysfunction depends on the potency and dose of medication used; however, it does not appear to result in significant morbidity.

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Section: Comparison With Other Anesthetic Modalitiesmentioning

confidence: 99%

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

Choi

Mahon

Awad

2012

Can J Anesth/J Can Anesth

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“…Catheterization carries a risk of urethral dilatation, trauma, stricture, bacteruria, and UTI, and it has a negative psychological impact on the parturient [8,12]. Earlier studies found that emptying the urinary bladder has no effect on uterine dynamic activity [6] as measured before and after catheterization in the same patients.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors found no effect [5,9], while others found distinct bladder function disturbances, attributed to local anesthetics [6,7,10,11,17]. The reported rate of urinary retention during labor with epidural analgesia ranges between 21% and 53% [4,5,8,9,11,12,18,19], as compared with zero incidence of retention with intramuscular meperidine [20].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, it is not clear which method of bladder emptying, by either continuous or intermittent catheterization, is associated with a higher incidence of urinary tract infection (UTI), or the impact of these methods on labor duration and outcome. In two previous studies [8,9], the reported rate of urinary retention in parturients receiving epidural analgesia was approximately 30%. Hence, some authors [10] advocate bladder assessment in every obstetrical examination during labor and delivery.…”

Section: Introductionmentioning

confidence: 92%

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The effect of intermittent versus continuous bladder catheterization on labor duration and postpartum urinary retention and infection: a randomized trial

Evron

Dimitrochenko

Khazin

et al. 2008

Journal of Clinical Anesthesia

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“…In an effort to reduce infections, studies have attempted to understand if intrapartum ultrasound estimation of bladder volume could assist in identifying patients in need of catheterization for urinary drainage in order to determine which patients need catheterization [9,10]. Reduction of infections is an important current national patient safety initiative.…”

mentioning

confidence: 99%

Intermittent versus continuous bladder catheterization during labor: does it matter?

Srinivas

2008

Journal of Clinical Anesthesia

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Patient-controlled epidural analgesia: the role of epidural fentanyl in peripartum urinary retention

Cited by 11 publications

References 26 publications

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

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

The effect of intermittent versus continuous bladder catheterization on labor duration and postpartum urinary retention and infection: a randomized trial

Intermittent versus continuous bladder catheterization during labor: does it matter?

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