Postoperative urinary retention following hip or knee arthroplasty under spinal anaesthesia with intrathecal morphine: a retrospective cohort study.
10.4103/singaporemedj.SMJ-2022-108
- Author:
Elad DANA
1
;
Oz BEN-ZUR
1
;
Sara DICHTWALD
1
;
Guy FEIGIN
1
;
Noa BRIN
2
;
Michael MARKUSHEVICH
2
;
Brian FREDMAN
1
;
Yaron Shraga BRIN
2
Author Information
1. Department of Anaesthesiology, Intensive Care and Pain Medicine, Meir Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel.
2. Department of Orthopedic surgery, Meir Medical Center, Affiliated to the Sackler School of Medicine, Tel Aviv University, Israel.
- Publication Type:Journal Article
- Keywords:
Intrathecal morphine;
postoperative complications;
spinal anaesthesia;
urinary retention
- MeSH:
Humans;
Retrospective Studies;
Male;
Urinary Retention/epidemiology*;
Arthroplasty, Replacement, Knee/adverse effects*;
Anesthesia, Spinal/adverse effects*;
Female;
Arthroplasty, Replacement, Hip/adverse effects*;
Morphine/adverse effects*;
Aged;
Middle Aged;
Risk Factors;
Postoperative Complications/epidemiology*;
Injections, Spinal;
Incidence;
Analgesics, Opioid/adverse effects*;
Aged, 80 and over
- From:Singapore medical journal
2025;66(9):481-485
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Postoperative urinary retention (POUR) frequently complicates the course of patients following hip and knee arthroplasty. Intrathecal morphine (ITM) was identified as a significant risk factor for POUR. The objective of this study was to investigate the incidence and risk factors for POUR in fast-track total joint arthroplasty (TJA) under spinal anaesthesia (SA) with ITM.
METHODS:We conducted a retrospective study of our institutional joint registry of patients who underwent primary TJA under SA with ITM between October 2017 and May 2021. Preoperative (baseline demographics) and perioperative data were collected. The primary outcome was the incidence of POUR after 8 h or earlier, either due to lack of voiding or according to patient's complaints of bladder distension. Univariate and adjusted analyses were performed to identify predictors of POUR.
RESULTS:Sixty-nine patients who underwent total knee arthroplasty (TKA) and 36 patients who underwent total hip arthroplasty (THA) under SA with ITM were included in the study. POUR requiring bladder catheterisation was diagnosed in 21% of patients. Independent predictors of POUR were age over 65 years and male gender.
CONCLUSIONS:SA with ITM for TJA is associated with high rates of POUR in males older than 65 years of age. Other previously identified risk factors such as intraoperative fluid administration or comorbidities may not be as influential.
