Patient-Controlled Analgesia and Peripheral Nerve Block Increase the Risk of Post-operative Urinary Retention after Total Knee Arthroplasty in Asian Patients
https://doi.org/10.5704/MOJ.2407.006
- Author:
Kwan YH
1
;
Tan KG
1
Author Information
1. Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore
- Publication Type:Journal Article
- Keywords:
urinary, retention, knee, arthroplasty, analgesia
- From:Malaysian Orthopaedic Journal
2024;18(No.2):42-48
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: Post-operative urinary retention (POUR) is a
common complication after total knee arthroplasty (TKA)
and may result in severe complications such as urinary tract
infection and deep joint sepsis, leading to prolonged hospital
stay and increased medical costs. Hence a retrospective
study was performed to identify the incidence and
modifiable factors associated with POUR after elective TKA
in Asian patients with the aim to prevent POUR and its
undesirable consequences.
Materials and methods: The medical records of 496
consecutive patients who underwent elective TKA between 1
August 2017 and 30 July 2018 were reviewed. There were
154 male (31.0%) and 342 female (69.0%) patients with an
average age of 68 years old. The incidence of POUR was
analysed with respect to various modifiable and nonmodifiable risk factors, including patient demographics,
medical comorbidities, duration of surgery, type of intraoperative anaesthesia and post-operative analgesia and early
initiation of physiotherapy using univariate and multivariate
analyses.
Results: A total of 120 (24.2%) of the 496 patients who
underwent elective TKA developed POUR. The odds of a
patient with patient-controlled analgesia (PCA) and
peripheral nerve block (PNB) developing POUR were 4.2
times and 4.7 times that of a patient without PCA and PNB,
respectively. Age, male gender and type of anaesthesia were
not found to be significant.
Conclusion: In our study population, the incidence of POUR
after elective TKA was 24% with major modifiable risk
factors being associated with the use of PCA and PNB as
post-operative anaesthesia. POUR can have deleterious
effects thus alternative post-operative analgesia should be
considered.
- Full text:202408211144070875516.2024my1371.pdf
