Abstract：
INTRODUCTION:Postoperative urinary retention requiring urethral catheterisation increases the risk of joint sepsis following arthroplasty. Spinal anaesthesia with opiate administration is used widely in lower limb arthroplasty. We sought to establish whether the choice of opiate agent had any effect on the incidence of postoperative retention and therefore the risk of joint sepsis. METHODS:A total of 445 consecutive patients who underwent primary elective lower limb arthroplasty were reviewed retrospectively. Patients had general anaesthesia and femoral nerve block (GA+FNB), spinal anaesthesia and intrathecal fentanyl (SA+ITF) or spinal anaesthesia and intrathecal morphine (SA+ITM). RESULTS:Urinary retention was observed in 14% of male and 2% of female patients with GA+FNB, 9% of male and 3% of female patients with SA+ITF, and 60% of male (p=0.0005) and 5% of female patients with SA+ITM. Men who experienced retention were older (68 vs 64 years, p=0.013) and had longer inpatient stays (6.7 vs 4.6 days, p=0.043). Fewer patients in the SA+ITM group required breakthrough analgesia (28% vs 58%, p=0.004). Concusions: The use of ITM in men significantly increases the incidence of urinary retention requiring urethral catheterisation and subsequently increases the risk of deep joint sepsis. Its use should be rationalised against the intended benefits and alternatives sought where possible.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Fernandez MA,Karthikeyan S,Wyse M,Foguet Pdoi
10.1308/003588414X13946184902523subject
Has Abstractpub_date
2014-09-01 00:00:00pages
462-5issue
6eissn
0035-8843issn
1478-7083journal_volume
96pub_type
杂志文章abstract：:We present the case of a 27-year-old man who underwent percutaneous atrial septal defect (ASD) repair using the Amplatzer(®) (St Jude Medical, St Paul, MN, US) septal occluder (ASO). Six weeks later, he presented with heart failure and was found to have an aorto-right atrial fistulation. He required urgent surgical de...
journal_title：Annals of the Royal College of Surgeons of England
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abstract：:The recording of medical data has developed from crude non-specific classifications to complex systems tailor-made for individual practices. The development of the Read Clinical Classification has produced a complex classification which is user friendly and covers the whole of medicine. The classification allows uniqu...
journal_title：Annals of the Royal College of Surgeons of England
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更新日期：1994-05-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
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更新日期：1990-01-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
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journal_title：Annals of the Royal College of Surgeons of England
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更新日期：1979-03-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
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更新日期：2006-07-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
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更新日期：1985-05-01 00:00:00
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更新日期：2017-01-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章,meta分析,评审
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更新日期：2014-04-01 00:00:00
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doi：10.1308/003588412X13171221498460
更新日期：2012-03-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
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doi：
更新日期：1995-07-01 00:00:00
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journal_title：Annals of the Royal College of Surgeons of England
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journal_title：Annals of the Royal College of Surgeons of England
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doi：
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journal_title：Annals of the Royal College of Surgeons of England
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journal_title：Annals of the Royal College of Surgeons of England
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