Document Detail


Incidence of urinary retention in patients with thoracic patient-controlled epidural analgesia (TPCEA) undergoing thoracotomy.
MedLine Citation:
PMID:  19481048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Up to 100% of patients treated with epidural analgesia can experience urinary retention, which may be related to dermatomal level of the epidural block, epidural medication, and surgical procedure. This study was designed to identify the incidence of urinary retention in patients who receive thoracic patient-controlled epidural analgesia (TPCEA) after thoracotomy. Forty-nine patients were enrolled and received epidural infusion of ropivacaine 0.2% or mixture of bupivacaine 0.1% with hydromorphone 0.015 mg/mL. Epidural catheter placement level was verified by chest X-rays. Indwelling urinary catheters were removed between 12 and 48 h after surgery when no longer required for fluid monitoring. Four hours later, patients were assessed for urinary retention using bladder ultrasound. Residual bladder volume was recorded, and urinary retention was defined as an inability to void or a bladder volume of greater than 600 mL at 4 h. Twenty-four hours after the catheter removal, patients completed a questionnaire to assess their perception of the indwelling catheter before and after its removal. Five participants (approximately 10%) with epidural catheters between T3 and T5 with bupivacaine/hydromorphone epidural solution were recatheterized. No association was established between catheter level, drug type, infusion rate, and urinary retention. Although 76% of patients did not report any physical discomfort with the indwelling urinary catheter, 66% felt relief after its removal and 18% did not ambulate with the inserted urinary catheter. The incidence of postoperative urine retention was low (10%), indicating that unless required for other purposes, indwelling urinary catheters may be removed between 12 and 48 h after surgery while receiving TPCEA.
Authors:
Salima S J Ladak; Rita Katznelson; Meredith Muscat; Monakshi Sawhney; William Scott Beattie; Gerald O'Leary
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pain management nursing : official journal of the American Society of Pain Management Nurses     Volume:  10     ISSN:  1532-8635     ISO Abbreviation:  Pain Manag Nurs     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-01     Completed Date:  2009-08-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100890606     Medline TA:  Pain Manag Nurs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  94-8     Citation Subset:  IM; N    
Affiliation:
Acute Pain Service, Department of Anesthesia and Pain Management, University Health Network, Toronto General Hospital, 200 Elizabeth Street, 3 Eaton North, Toronto, Ontario M5G2C4, Canada. salima.ladak@uhn.on.ca
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MeSH Terms
Descriptor/Qualifier:
Analgesia, Epidural* / adverse effects,  psychology
Analgesia, Patient-Controlled* / adverse effects,  psychology
Analysis of Variance
Attitude to Health*
Female
Humans
Incidence
Male
Middle Aged
Nursing Methodology Research
Pain, Postoperative / drug therapy,  etiology
Postoperative Care / adverse effects,  methods,  psychology
Qualitative Research
Questionnaires
Thoracic Vertebrae
Thoracotomy* / adverse effects
Time Factors
Urinary Catheterization / adverse effects,  psychology
Urinary Retention / chemically induced*,  epidemiology*,  prevention & control,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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