Postoperative Urinary Catheterization in Children Treated with or without Epidural Analgesia after Orthopedic Surgery: A Retrospective Review of Practice
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population and Data Collection
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Lerman, J.; Nolan, J.; Eyres, R.; Schily, M.; Stoddart, P.; Bolton, C.M.; Mazzeo, F.; Wolf, A.R. Efficacy, safety, and pharmacokinetics of levobupivacaine with and without fentanyl after continuous epidural infusion in children: A multicenter trial. Anesthesiology 2003, 99, 1166–1174. [Google Scholar] [CrossRef] [PubMed]
- Murat, I.; Delleur, M.M.; Esteve, C.; Egu, J.F.; Raynaud, P.; Saint-Maurice, C. Continuous extradural anaesthesia in children. Clinical and haemodynamic implications. Br. J. Anaesth. 1987, 59, 1441–1450. [Google Scholar] [CrossRef] [PubMed]
- Maria, B.D.J.; Tielens, L.; Roberts, S. Pediatric Epidural and Spinal Anesthesia and Analgesia. Available online: https://www.nysora.com/topics/sub-specialties/pediatric-anesthesia/pediatric-epidural-spinal-anesthesia-analgesia/ (accessed on 22 August 2022).
- Dellimore, K.H.; Helyer, A.R.; Franklin, S.E. A scoping review of important urinary catheter induced complications. J. Mater. Sci. Mater. Med. 2013, 24, 1825–1835. [Google Scholar] [CrossRef] [PubMed]
- Garin, C. Enhanced recovery after surgery in pediatric orthopedics (ERAS-PO). Orthop. Traumatol. Surg. Res. OTSR 2020, 106, S101–S107. [Google Scholar] [CrossRef]
- Ecoffey, C.; Lacroix, F.; Giaufre, E.; Orliaguet, G.; Courreges, P. Association des Anesthesistes Reanimateurs Pediatriques d’Expression, F. Epidemiology and morbidity of regional anesthesia in children: A follow-up one-year prospective survey of the French-Language Society of Paediatric Anaesthesiologists (ADARPEF). Paediatr. Anaesth. 2010, 20, 1061–1069. [Google Scholar] [CrossRef] [PubMed]
- Walker, B.J.; Long, J.B.; Sathyamoorthy, M.; Birstler, J.; Wolf, C.; Bosenberg, A.T.; Flack, S.H.; Krane, E.J.; Sethna, N.F.; Suresh, S.; et al. Complications in Pediatric Regional Anesthesia: An Analysis of More than 100,000 Blocks from the Pediatric Regional Anesthesia Network. Anesthesiology 2018, 129, 721–732. [Google Scholar] [CrossRef] [PubMed]
- Baldini, G.; Bagry, H.; Aprikian, A.; Carli, F. Postoperative urinary retention: Anesthetic and perioperative considerations. Anesthesiology 2009, 110, 1139–1157. [Google Scholar] [CrossRef] [PubMed]
- De Leon, L.E.; Patil, N.; Hartigan, P.M.; White, A.; Bravo-Iniguez, C.E.; Fox, S.; Tarascio, J.; Swanson, S.J.; Bueno, R.; Jaklitsch, M.T. Risk of Urinary Recatheterization for Thoracic Surgical Patients with Epidural Anesthesia. J. Surg. Res. 2020, 3, 163–171. [Google Scholar] [CrossRef] [PubMed]
- Cha, Y.H.; Lee, Y.K.; Won, S.H.; Park, J.W.; Ha, Y.C.; Koo, K.H. Urinary retention after total joint arthroplasty of hip and knee: Systematic review. J. Orthop. Surg. 2020, 28, 2309499020905134. [Google Scholar] [CrossRef] [PubMed]
- Gupta, A.; Jay, M.A.; Williams, G. Evolving pediatric epidural practice: An institution’s clinical experience over 20 years-A retrospective observational cohort study. Paediatr. Anaesth. 2020, 30, 25–33. [Google Scholar] [CrossRef] [PubMed]
- Wood, C.E.; Goresky, G.V.; Klassen, K.A.; Kuwahara, B.; Neil, S.G. Complications of continuous epidural infusions for postoperative analgesia in children. Can. J. Anaesth. J. Can. D’Anesthesie 1994, 41, 613–620. [Google Scholar] [CrossRef] [PubMed]
- Buckon, C.E.; Koscielniak, N.J.; Tucker, C.A.; Aiona, M.D. Mode of Anesthesia and Bladder Management Following Orthopaedic Surgery in Children with Cerebral Palsy: A System Level Analysis. J. Pediatric Orthop. 2022, 42, e544–e549. [Google Scholar] [CrossRef] [PubMed]
- Brenn, B.R.; Brislin, R.P.; Rose, J.B. Epidural analgesia in children with cerebral palsy. Can. J. Anaesth. J. Can. D’Anesthesie 1998, 45, 1156–1161. [Google Scholar] [CrossRef] [PubMed]
- Wald, H.L.; Ma, A.; Bratzler, D.W.; Kramer, A.M. Indwelling urinary catheter use in the postoperative period: Analysis of the national surgical infection prevention project data. Arch. Surg. 2008, 143, 551–557. [Google Scholar] [CrossRef] [PubMed]
- Coyle, D.; Joyce, K.M.; Garvin, J.T.; Regan, M.; McAnena, O.J.; Neary, P.M.; Joyce, M.R. Early postoperative removal of urethral catheter in patients undergoing colorectal surgery with epidural analgesia-a prospective pilot clinical study. Int. J. Surg. 2015, 16, 94–98. [Google Scholar] [CrossRef] [PubMed]
Total Population (n = 239) | Non-Epidural (n = 182) | Epidural (n = 57) | p-Value | |
---|---|---|---|---|
Age at operation, years | 9.2 (5.0) | 9.5 (5.1) | 8.1 (4.3) | 0.03 |
Age < 1 year | 20 (8.7%) | 20 (12%) | 0 (0%) | 0.005 |
Gender, female | 101 (42.4%) | 77 (42.5%) | 24 (42.1%) | 0.95 |
Weight, kg | 35 (24) | 38 (26) | 25 (16) | 0.001 |
ASA-PS score | 2 [1, 2] | 2 [1, 2] | 2 [2, 3] | 0.005 |
Neuromuscular disease a | 57 (24%) | 36 (20%) | 21 (37%) | 0.008 |
Intraoperative crystalloid administration, mL/kg | 27 (28) | 22 (25) | 43 (31) | <0.001 |
Intraoperative packed cells transfusion y/n | 10 (4%) | 6 (3%) | 4 (7%) | 0.26 |
Length of surgery, hours | 2.5 [1.1–3.5] | 1.5 [1.0, 2.8] | 3.6 [2.7, 4.1] | <0.001 |
Variable | Total Population (n = 239) | Non-Epidural (n = 182) | Epidural (n = 57) | p-Value | Non-NMD a (n = 182) | NMD a (n = 57) | p-Value | ||
---|---|---|---|---|---|---|---|---|---|
UC placement | No | 155 (65%) | 151 (83%) | 4 (6%) | <0.001 | 134 (73%) | 21 (37%) | 0.004 | |
Yes | OR | 75 (31%) | 28 (15%) | 47 (82%) | <0.001 | 40 (22%) | 35 (61%) | <0.001 | |
Ward | 9 (4%) | 3 (2%) | 6 (11%) | 0.007 | 8 (4%) | 1 (2%) | 0.69 | ||
UC re-insertion in surgical ward | 7 (3%) | 4 (2%) | 3 (5%) | 0.36 | 1 (3%) | 6 (17%) | 0.001 | ||
Duration of UC use, days (median [IQR]) | 2 [1, 3] | 1 [0, 2] | 3 [1, 3] | 0.01 | 1 [0.75, 3] | 3 [2, 3] | 0.003 | ||
Duration of epidural use, days (median [IQR]) | 3 [2, 3] | n/a | 3 [2, 3] | n/a | 3 [2, 3] | 3 [3, 3] | 0.06 |
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Lior, Y.; Haim, S.; Katz, I.; Danino, B.; Bar-Yosef, Y.; Ekstein, M. Postoperative Urinary Catheterization in Children Treated with or without Epidural Analgesia after Orthopedic Surgery: A Retrospective Review of Practice. Children 2022, 9, 1316. https://doi.org/10.3390/children9091316
Lior Y, Haim S, Katz I, Danino B, Bar-Yosef Y, Ekstein M. Postoperative Urinary Catheterization in Children Treated with or without Epidural Analgesia after Orthopedic Surgery: A Retrospective Review of Practice. Children. 2022; 9(9):1316. https://doi.org/10.3390/children9091316
Chicago/Turabian StyleLior, Yotam, Shimon Haim, Idan Katz, Barry Danino, Yuval Bar-Yosef, and Margaret Ekstein. 2022. "Postoperative Urinary Catheterization in Children Treated with or without Epidural Analgesia after Orthopedic Surgery: A Retrospective Review of Practice" Children 9, no. 9: 1316. https://doi.org/10.3390/children9091316