Postoperative urinary retention after general and spinal anesthesia in orthopedic surgical patients

Abstract

Background: After general, spinal anesthesia and surgery, urinary retention is common. The aim of the study was to compare the effect of general anesthesia versus spinal anesthesia on postoperative urinary retention Patients and methods: After obtaining local ethics committee approval and written consent, 60 male patients, aged 16–40 years, ASA – physical status I and II were divided into two groups (S) 40 patients and (G) 20 patients undergoing surgery of the lower limb lasting up to 90 min (knee arthroscopy, internal tibial fixation with plate and screws). Group (S) was taken spinal anesthesia, this group was divided into two groups (S1) 20 patients, who were taken plain bupivacaine and group (S2) 20 patients who were taken plain bupivacaine plus fentanyl. Group (G) 20 patients were anesthetized by general anesthesia. Results: There were statistically significant differences among groups S1, S2 and G regarding spontaneous micturition, residual volume and time since spinal or general anesthesia till micturition. The percent numbers of patients with retention were 20% in group S1, 35% in group S2 and 8% in group G. Conclusion: Urinary retention is more common after spinal than general anesthesia in orthopedic patients. Adding narcotics to the local anesthetics intrathecally causes more incidence of postoperative urinary retention, which may delay patients discharge and transabdominal ultrasonography is a reliable, noninvasive, inexpensive and simple method to measure bladder volume postoperatively.

Keywords

• General anesthesia
• Spinal anesthesia
• Narcotic analgesics urinary retention