在全身麻醉联合脊髓麻醉并使用鞘内阿片类药物的情况下进行初次全髋关节置换术后，尿潴留发生率较高。
High rates of postoperative urinary retention following primary total hip replacement performed under combined general and spinal anaesthesia with intrathecal opiate.
作者信息
David Michael, Arthur Elizabeth, Dhuck Raveena, Hemmings Ellie, Dunlop David
机构信息
West Midlands Deanery, Trauma & Orthopaedic Training Programme, Birmingham B16 9RG, United Kingdom.
West Midlands Deanery, GP Training Programme, South Birmingham B16 9RG, United Kingdom.
出版信息
J Orthop. 2015 Nov 18;12(Suppl 2):S157-60. doi: 10.1016/j.jor.2015.10.020. eCollection 2015 Dec.
Abstract
BACKGROUND
Postoperative urinary retention (POUR) occurs frequently following hip replacement.
METHODS
94 consecutive primary hip arthroplasty patients were assessed prospectively for POUR. 80 patients followed our anaesthesia protocol with combined general and spinal anaesthesia using bupivacaine and intrathecal diamorphine.
RESULTS
29 instances of POUR with higher rates in men and younger patients (under-50s), independent of either pre-existing renal impairment or opiate strength. POUR was observed to increase length of stay by 1.6 days.
CONCLUSIONS
We report a 36% overall rate of POUR. Males demonstrated a 3-fold increased risk. Patients should be counselled pre-operatively on the risk of urinary retention.
摘要
背景
髋关节置换术后经常发生术后尿潴留（POUR）。
方法
对94例连续进行初次髋关节置换术的患者进行前瞻性POUR评估。80例患者遵循我们的麻醉方案，采用布比卡因和鞘内注射二氢吗啡进行全身麻醉和脊髓麻醉联合。
结果
发生29例POUR，男性和年轻患者（50岁以下）的发生率较高，与既往存在的肾功能损害或阿片类药物强度无关。观察到POUR使住院时间延长1.6天。
结论
我们报告POUR的总体发生率为36%。男性的风险增加了3倍。应在术前向患者咨询尿潴留的风险。
相似文献
1
High rates of postoperative urinary retention following primary total hip replacement performed under combined general and spinal anaesthesia with intrathecal opiate.
J Orthop. 2015 Nov 18;12(Suppl 2):S157-60. doi: 10.1016/j.jor.2015.10.020. eCollection 2015 Dec.
2
Postoperative urinary retention following hip or knee arthroplasty under spinal anaesthesia with intrathecal morphine: a retrospective cohort study.
Singapore Med J. 2023 Jun 13. doi: 10.4103/singaporemedj.SMJ-2022-108.
3
Incidence and Risk Factors for Postoperative Urinary Retention in Total Hip Arthroplasty Performed Under Spinal Anesthesia.
J Arthroplasty. 2017 Dec;32(12):3748-3751. doi: 10.1016/j.arth.2017.07.009. Epub 2017 Jul 15.
4
Low incidence of postoperative urinary retention with the use of a nurse-led bladder scan protocol after hip and knee arthroplasty: a retrospective cohort study.
Eur J Orthop Surg Traumatol. 2018 Feb;28(2):283-289. doi: 10.1007/s00590-017-2042-5. Epub 2017 Sep 12.
5
Incidence and Risk Factors of Postoperative Urinary Retention and Bladder Catheterization in Patients Undergoing Fast-Track Total Joint Arthroplasty: A Prospective Observational Study on 371 Patients.
J Arthroplasty. 2018 May;33(5):1546-1551. doi: 10.1016/j.arth.2017.12.001. Epub 2017 Dec 13.
6
Risk factors of postoperative urinary retention following total hip and knee arthroplasty.
Bone Jt Open. 2024 Jul 18;5(7):601-611. doi: 10.1302/2633-1462.57.BJO-2024-0003.R1.
7
Routine Indwelling Urinary Catheterization Is Not Necessary During Total Hip Arthroplasty Performed Under Spinal Anesthesia.
Arthroplast Today. 2022 May 28;16:68-72. doi: 10.1016/j.artd.2022.04.015. eCollection 2022 Aug.
8
Is epidural anaesthesia acceptable at total hip arthroplasty? A study of the rates of urinary catheterisation.
J Bone Joint Surg Br. 2004 Nov;86(8):1115-7. doi: 10.1302/0301-620x.86b8.14240.
9
Would early removal of indwelling catheter effectively prevent urinary retention after hip fracture surgery in elderly patients?
J Orthop Surg Res. 2019 Sep 18;14(1):315. doi: 10.1186/s13018-019-1360-1.
10
Spinal anaesthesia with adjunctive intrathecal morphine versus continuous lumbar plexus blockade: a randomised comparison for analgesia after hip replacement.
Anaesth Intensive Care. 2015 Jul;43(4):449-53. doi: 10.1177/0310057X1504300405.
引用本文的文献
1
An economic evaluation of a hospital-wide bundle intervention to reduce hospital-acquired infections and bladder distension among hip fracture patients in Sweden.
Antimicrob Resist Infect Control. 2025 Jul 3;14(1):80. doi: 10.1186/s13756-025-01573-y.
2
The Effect of Sevoflurane and Propofol on the Status of Renal Complications in Traumatic Injury Patients Following Laminectomy Surgery.
Bull Emerg Trauma. 2024;12(4):162-167. doi: 10.30476/beat.2024.103200.1523.
3
Risk factors of postoperative urinary retention following total hip and knee arthroplasty.
Bone Jt Open. 2024 Jul 18;5(7):601-611. doi: 10.1302/2633-1462.57.BJO-2024-0003.R1.
4
Post-operative Urinary Dysfunction Following Shoulder Surgery: Rates and Risk Factors.
Arch Bone Jt Surg. 2022 Dec;10(12):1020-1025. doi: 10.22038/ABJS.2022.62834.3050.
5
Incidence, Outcomes, and Prediction of Postoperative Urinary Retention After a Nonurologic Procedure.
J Am Acad Orthop Surg Glob Res Rev. 2020 May;4(5):e1900149. doi: 10.5435/JAAOSGlobal-D-19-00149.
6
Would early removal of indwelling catheter effectively prevent urinary retention after hip fracture surgery in elderly patients?
J Orthop Surg Res. 2019 Sep 18;14(1):315. doi: 10.1186/s13018-019-1360-1.
本文引用的文献
1
Urinary retention after total hip and knee arthroplasty.
Minerva Anestesiol. 2010 Feb;76(2):120-30.
2
Predictors of postoperative urinary retention.
Am Surg. 2009 Oct;75(10):922-4. doi: 10.1177/000313480907501012.
3
Postoperative urinary retention: anesthetic and perioperative considerations.
Anesthesiology. 2009 May;110(5):1139-57. doi: 10.1097/ALN.0b013e31819f7aea.
4
Urinary retention following lower limb arthroplasty: analysis of predictive factors and review of literature.
Acta Orthop Belg. 2008 Jun;74(3):332-6.
5
Identification of risk factors for urinary retention following total knee arthroplasty: a Singapore hospital experience.
Singapore Med J. 2007 Mar;48(3):213-6.
6
Urinary catheterisation and deep wound infection after hip fracture surgery.
Int Orthop. 2007 Aug;31(4):483-5. doi: 10.1007/s00264-006-0227-3. Epub 2006 Aug 15.
7
Can a urinary tract symptom score predict the development of postoperative urinary retention in patients undergoing lower limb arthroplasty under spinal anaesthesia? A prospective study.
Ann R Coll Surg Engl. 2006 Jul;88(4):394-8. doi: 10.1308/003588406X106531.
8
Parameters affecting urologic complications after major joint replacement surgery.
Can J Urol. 2006 Jun;13(3):3158-63.
9
Epidural analgesia improves early rehabilitation after total knee replacement.
J Clin Anesth. 2005 Jun;17(4):281-5. doi: 10.1016/j.jclinane.2004.08.008.
10
The role of the IPSS (International Prostate Symptoms Score) in predicting acute retention of urine in patients undergoing major joint arthroplasty.
Surgeon. 2005 Apr;3(2):63-5. doi: 10.1016/s1479-666x(05)80063-0.
Zotero 插件