Incidence of post operative urinary retention and duration of spontaneous micturition after spinal block for Herniorrhaphy and Hemorrhoidectomy in Yasothon hospital. Division of Anesthesiology, Yasothon Hospital
Abstract
Background : Post operative urinary retension(POUR) after spinal block can lead to morbidities such as pain, delirium, UTI, Cardiovascular events which is why successful micturition is important discharge criteria in many centres.The reported incidence varies between 0-69%.Multiple factors and etiology have been reported for occurrence of POUR.As a result,spinal block were ignored in One Day Surgery (ODS).
Objective : To be aware of the incidence of postoperative incontinence and the length of time a patient can urinate after spinal block for Herniorrhaphy and Hemorrhoidectomy.
Method : ASA status I-III 105 patients undergoing spinal block for Hemorrhoidectomy and Herniorrhaphy were enrolled. Preload with NSS 5 ml/kg, using 0.5% heavy Marcaine 2.4-3.0 ml for Herniorrhaphy and 1 ml for Hemorrhoidectomy.Patients will received Dynastat 40 mg iv, 0.25% Marcaine 10-20 ml for ilioinguinal nerve block and local infiltration analgesia.Post operative pain were controlled with Paracetamol combined NSAIDs, The number of patients who can not be spontaneous
urinated and catheterization were recorded.
Result : 105 patients were completed the study, nobody required catheterization. All can spontaneous micturition within 8 hours after spinal block(100 percent). The amount of intravenous fluid and volume of anesthetic agent is statistically associated with duration of spontaneous micturition.
Conclusion : A reduction in the incidence of POUR in Herniorrhaphy and Hemorrhoidectomy can be done by selecting low risk patients and reduce risk predisposing factors such as voiding before operation, reduced excessive intravenous fluid, decreased local anesthetic agent and adequate pain management.
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