Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Anichstr. 35, 6020 Innsbruck, Austria.
Br J Anaesth. 2010 May;104(5):582-6. doi: 10.1093/bja/aeq054. Epub 2010 Mar 25.
Hyperbaric prilocaine 2% is a medium long-acting spinal anaesthetic. There are few data on time to recovery and rate of urinary retention after spinal administration of hyperbaric prilocaine 2%. This prospective study was carried out to evaluate the time to spontaneous micturition, quantify the rate of necessary bladder catheterizations, and identify the risk factors for urinary retention after intrathecal prilocaine administration.
ASA I/II patients (16-80 yr) undergoing ambulatory lower limb surgery were enrolled and received spinal anaesthesia using hyperbaric prilocaine 2% (60 mg). Ringer's lactate was administered for peroperative volume replacement. Bladder ultrasound was performed hourly until spontaneous micturition or catheterization, when bladder filling reached 600 ml, and they were unable to urinate spontaneously.
Eighty-six patients completed the study (49 males and 37 females). Mean (sd) fluid administration was 1200 (499) ml until either micturition or catheterization; 37.8% of the women and 12.2% of the men required catheterization (P=0.009). Mean (sd) time between spinal anaesthesia and catheterization was 190 (88) min, and 260 (61) min to micturition (P<0.0001). Age <40 or >60 yr and female gender were predisposing factors for urinary retention.
After spinal anaesthesia with hyperbaric prilocaine 2% (60 mg) for ambulatory lower limb surgery, 23% of patients required postoperative urinary catheterization. Postoperative bladder ultrasound and early catheterization are essential to avoid bladder distension and facilitate discharge in patients after intrathecal prilocaine 2% administration in ambulatory surgery.
高比重布比卡因 2%是一种中长效的椎管内麻醉药。关于椎管内给予高比重布比卡因 2%后恢复时间和尿潴留发生率的数据较少。本前瞻性研究旨在评估自主排尿的时间，量化必要的导尿率，并确定椎管内给予布比卡因后发生尿潴留的危险因素。
ASA I/II 级（16-80 岁）择期行下肢手术的患者接受高比重布比卡因 2%（60mg）行椎管内麻醉。术中给予林格氏乳酸钠进行容量替代。膀胱超声每小时进行一次，直至自主排尿或导尿，当膀胱充盈达到 600ml 且无法自主排尿时进行导尿。
86 例患者完成了研究（49 例男性和 37 例女性）。导尿前平均（标准差）液体输入量为 1200（499）ml；女性中有 37.8%和男性中有 12.2%需要导尿（P=0.009）。椎管内麻醉后至导尿的平均（标准差）时间为 190（88）min，至自主排尿的时间为 260（61）min（P<0.0001）。年龄<40 岁或>60 岁以及女性是发生尿潴留的易患因素。
在下肢手术的椎管内麻醉中使用高比重布比卡因 2%（60mg）后，23%的患者需要术后导尿。术后膀胱超声检查和早期导尿对于避免膀胱扩张和促进椎管内给予高比重布比卡因 2%后接受门诊手术的患者出院是必要的。
