Indwelling Urinary Catheter for Total Joint Arthroplasty Using Epidural Anesthesia
| Autor: | Oliver J. Scotting, Wayne T. North, Michael A. Charters, Chaoyang Chen |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Anesthesia
Epidural Male Risk Urinary system medicine.medical_treatment Arthroplasty Replacement Hip Urinary Catheters 03 medical and health sciences Prostate cancer 0302 clinical medicine Catheters Indwelling Postoperative Complications Prostate Medicine Humans Orthopedics and Sports Medicine Postoperative Period Prospective Studies Arthroplasty Replacement Knee Aged Retrospective Studies 030222 orthopedics business.industry Genitourinary system Hyperplasia Middle Aged medicine.disease Arthroplasty Catheter medicine.anatomical_structure Anesthesia Urinary Tract Infections Female business Urinary Catheterization Body mass index |
| Zdroj: | The Journal of arthroplasty. 34(10) |
| ISSN: | 1532-8406 |
| Popis: | Background The objective of this study was to evaluate if not placing an indwelling urinary catheter leads to a higher potential for adverse genitourinary (GU) issues after total joint arthroplasty (TJA) under epidural anesthesia. Methods Three hundred thirty-five consecutive patients who underwent primary TJA using epidural anesthesia were retrospectively reviewed. The initial 103 patients received a preoperative urinary catheter, which was maintained until the morning of postoperative day 1. The subsequent 232 patients did not receive a preoperative urinary catheter. Demographics, medical complications, GU complications, and length of stay were compared between groups. Results Compared between catheter and noncatheter groups, there were no differences in demographics including age, gender, or laterality of surgery. There was a difference in type of surgery (total knee arthroplasty vs total hip arthroplasty) (P = .008). There was no difference in American Society of Anesthesiologists score, but with a difference in body mass index (P = .01). There were no differences in GU complications among patients with benign prostatic hyperplasia or prostate cancer. However, among patients with a history of prostate disorders (benign prostatic hyperplasia or prostate cancer), urinary tract infection rate was higher in catheter group (P = .023). Postoperative GU complications were associated with increased median age in years and increased average length of stay in days. Conclusion Patients undergoing TJA under epidural anesthesia demonstrate no increased risk of postoperative urological complications without the placement of preoperative indwelling urinary catheter. The routine use of preoperative catheters can be reconsidered for this mode of anesthesia. Level of Evidence Level II, retrospective comparative study. |
| Databáze: | OpenAIRE |
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