| Retención urinaria postoperatoria; Consideraciones anestésicas y perioperatorias |
Postoperative Urinary Retention: Anesthetic and Perioperative Considerations
Baldini, Gabriele M.D., Bagry, Hema M.D., F.R.C.A., F.R.C.P.C., Aprikian, Armen M.D., F.R.C.S.C., Carli, Franco M.D., M.Phil., F.R.C.A., F.R.C.P.C.
Anesthesiology May 2009 - Volume 110 - Issue 5 - pp 1139-1157
Urinary retention is common after anesthesia and surgery, reported incidence of between 5% and 70%. Comorbidities, type of surgery, and type of anesthesia influence the development of postoperative urinary retention (POUR). The authors review the overall incidence and mechanisms of POUR associated with surgery, anesthesia and analgesia. Ultrasound has been shown to provide an accurate assessment of urinary bladder volume and a guide to the management of POUR. Recommendations for urinary catheterization in the perioperative setting vary widely, influenced by many factors, including surgical factors, type of anesthesia, comorbidities, local policies, and personal preferences. Inappropriate management of POUR may be responsible for bladder overdistension, urinary tract infection, and catheter-related complications. An evidence-based approach to prevention and management of POUR during the perioperative period is proposed.
http://journals.lww.com/anesthesiology/fulltext/2009/05000/postoperative_urinary_retention__anesthetic_and.33.aspx
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| Factores de riesgo para retención urinaria en pacientes hospitalizados |
Risk factors of post-operative urinary retention in hospitalised patients.
HANSEN, B. S., SØREIDE, E., WARLAND, A. M. and NILSEN, O. B.
Acta Anaesthesiologica Scandinavica, 2011;55: 545-548. doi: 10.1111/j.1399-6576.2011.02416.x
Background: Post-operative urinary retention (POUR) is most accurately determined by using ultrasound to measure bladder volume. The aim of this study was to define the risk factors of POUR in the recovery room in hospitalised patients. Methods: An ultrasound-determined bladder volume ≥400 ml at arrival in the recovery room was used to define POUR. Multivariate regression analysis was used to identify patient and system factors linked to POUR in 773 consecutive hospitalised patients who had undergone orthopaedic, abdominal, gynaecological or plastic surgery without an indwelling urinary catheter. Results: We found the incidence of POUR to be 13%. The lack of pre-operative voiding, use of regional anaesthesia, anaesthesia time >2 h and emergency surgery were all independent risk factors for POUR. Conclusions: The detected incidence of POUR at arrival in the recovery room was rather high but had easily identifiable risk factors. We recommend pre-operative voiding whenever possible. Routine bladder scanning at arrival in the recovery room should be considered, especially after spinal anaesthesia, emergency surgery or when the anaesthesia time exceeds 2 h.
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.2011.02416.x/pdf |
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