Key result
Epidural anaesthesia with fentanyl and bupivacaine supplementing general anaesthesia did not increase post-operative urinary catheterisation compared to general anaesthesia alone (13.3% vs 14.7%).
Why the study?
Does general anaesthesia supplemented by epidural anaesthesia using fentanyl and bupivacaine increase the rate of post-operative urinary catheterisation in patients undergoing total hip arthroplasty compared to general anaesthesia alone?
Cohort (n=173)
Does general anaesthesia supplemented by epidural anaesthesia using fentanyl and bupivacaine increase the rate of post-operative urinary catheterisation in patients undergoing total hip arthroplasty compared to general anaesthesia alone?
Absolute Event Rate: 13.3% vs 14.7%
Supplementing general anaesthesia with epidural anaesthesia using fentanyl and bupivacaine does not increase the risk of post-operative urinary catheterisation in patients undergoing total hip arthroplasty.
May reassure on epidural use without added catheterisation risk in hip arthroplasty; leaves open confirmation by randomized trials.
Epidural anaesthesia, with and without opiate, is widely used in total hip arthroplasty (THA). It may cause urinary retention, leading to catheterisation, and a subsequent increase in the likelihood of deep infection. We investigated prospectively the rate of urinary catheterisation in patients after THA performed under general anaesthesia, with or without peri-operative fentanyl and bupivacaine opiate epidural anaesthesia. Of 173 patients, 75 received general anaesthesia alone and 98 both general and epidural management. The post-operative rate of catheterisation was 14.7% in those who received general anaesthesia alone and 13.3% in those who received both. Our findings suggest that the rate of post-operative urinary catheterisation does not increase when general anaesthesia is supplemented by epidural anaesthesia using fentanyl and bupivicaine.
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MacDowell et al. (2004) conducted a cohort in Total hip arthroplasty (n=173). Epidural anaesthesia with fentanyl and bupivacaine vs. General anaesthesia alone was evaluated on Post-operative rate of urinary catheterisation. Epidural anaesthesia with fentanyl and bupivacaine supplementing general anaesthesia did not increase post-operative urinary catheterisation compared to general anaesthesia alone (13.3% vs 14.7%).
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