Urinary Retention in Unilateral Total Knee Arthroplasty: Comparison Between Continuous Epidural Analgesia and Single-shot Femoral Nerve Block. | [Journal of College of Physicians and Surgeons--Pakistan : JCPSP • 2018]

Author(s):

1. Ausaf Ahmed Khan: Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan

2. Robyna Irshad Khan: Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan

Abstract:

Objective: To compare the frequency of urinary retention and requirement of bladder catheterization in patients undergoing total knee arthroplasty while receiving either continuous epidural analgesia or single-shot femoral nerve block. Study Design: Randomized controlled study. Place and Duration of Study: Operating Rooms of Aga Khan University Hospital, Karachi, from January 2014 to January 2015. Methodology: Patients were randomized in two groups of 30 each, i.e. epidural group (group E) or femoral nerve block group (group F). Baseline parameters were recorded. Postoperatively, patients were followed for upto 24 hours to collect the data regarding urinary retention. Final outcome was taken at 24 hours postoperatively. Data was analyzed to compare the frequency of urinary retention between the two groups. Results: The average age of the patients was 59.58 ±5.85 years. There were 28 (46.7%) male and 32 (53.3%) female patients. Frequency of urinary retention was significantly high in Group E than Group F (46.7% vs. 6.7%; p=0.0005). Conclusion: Single-shot femoral nerve block offers a more favorable profile in terms of postoperative urinary retention when compared to continuous epidural analgesia.

Page(s): 5-8

DOI: DOI not available

Published: Journal: Journal of College of Physicians and Surgeons--Pakistan : JCPSP, Volume: 28, Issue: 1, Year: 2018

Keywords:

Keywords are not available for this article.

References:

[1] KumarP,MannanK,ChowdhuryAM,KongKC,PatiJ, 2006.Urinary retention and the role of indwelling catheterization following total knee arthroplasty,Int Braz J Urol 32 31 -4

[2] FernandezMA,KarthikeyanS,WyseM,FoguetP., 2014.The incidence of postoperative urinary retention in patients undergoing elective hip and knee arthroplasty,Ann R Coll Surg Engl 96 462 -5

[3] LingarajK,RubenM,ChanYH,DasSD, 2007.Identification of risk factors for urinary retention following total knee arthroplasty: a Singapore hospital experience,Singapore Med J 48 213 -

[4] LuY,HuangHM,YanJ,JiangH, 2017.Comparison of postoperative femoral nerve block, epidural block and intravenous patientcontrolled analgesia in pain control and postoperative rehabilitation after total knee arthroplasty,Int J Clin Exp Med 10 6680 -7

[5] MouchaCS,WeiserMC,LevinEJ, 2016.Current strategies in anesthesia and analgesia for total knee arthroplasty,J Am Acad Orthop Surg 24 60 -73

[6] CampbellA,McCormickM,McKinlayK,Scott NB, 2008.Epidural vs. lumbar plexus infusions following total knee arthroplasty: randomized controlled trial,Eur J Anaesthesiol 25 502 -7

[7] CapdevilaX,BartheletY,BibouletP,RyckwaertY,RubenovitchJ,d'Athis F, 1999.Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery,J Am Soc Anesthesiol 91 8 -15

[8] SingelynFJ,DeyaertM,JorisD,PendevilleE,GouverneurJM, 1998.Effects of intravenous patient-controlled analgesia with morphine, continuous epidural analgesia, and continuous three-in-one block on postoperative pain and knee rehabilitation after unilateral total knee arthroplasty,Anesth Analg 87 88 -92

[9] GerrardAD,BrooksB,AsaadP,HajibandehS,HajibandehS, 2017.Meta-analysis of epidural analgesia versus peripheral nerve blockade after total knee joint replacement,Eur J Orthop Surg Traumatol 27 61 -72

[10] FanL,YuX,ZanP,LiuJ,JiT,LiG, 2016.Comparison of local infiltration analgesia with femoral nerve block for total knee arthroplasty: a prospective, randomized clinical trial,J Arthroplasty 31 1361 -5

[11] BjerregaardLS,BagiP,KehletH, 2014.Postoperative urinary retention (POUR) in fast-track total hip and knee arthroplasty: A challenge for orthopedic surgeons,Acta Orthop 85 8 -10

[12] FowlerSJ,SymonsJ,SabatoS,MylesPS, 2008.Epidural analgesia compared with peripheral nerve blockade after major knee surgery: a systematic review and meta-analysis of randomized trials,Br J Anaest 100 154 -64

[13] ChoiP,BhandariM,ScottJ,DouketisJD, 2003.Epidural analgesia for pain relief following hip or knee replacement,Cochrane Database Syst Rev 3 CD003071 -

[14] CookP,StevensJ,GaudronC, 2003.Comparing the effects of femoral nerve block versus femoral and sciatic nerve block on pain and opiate consumption after total knee arthroplasty,J Arthroplasty 18 583 -6

[15] BalderiT,CarliF, 2010.Urinary retention after total hip and knee arthroplasty,Minerva Anestesiol 76 120 -30

[16] McQueenDA,KelleyHK,WrightTF, 1992.A comparison of epidural and non-epidural anesthesia and analgesia in total hip or knee arthroplasty patients,Orthopedics 15 169 -73

[17] SingelynFoJ,FerrantT,MalisseMF,JorisD., 2005.Effects of intravenous patient-controlled analgesia with morphine, continuous epidural analgesia, and continuous femoral nerve sheath block on rehabilitation after unilateral total-hip arthroplasty,Reg Anesth Pain Med 30 452 -7

[18] ChanEY,FransenM,ParkerDA,AssamPN,ChuaN., 2014.Femoral nerve blocks for acute postoperative pain after knee replacement surgery,Cochrane Database Syst Rev 5 CD009941 -

[19] ChuCP,YapJC,ChenPP,Hung HH, 2006.Postoperative outcome in Chinese patients having primary total knee arthroplasty under general anaesthesia/intravenous patient-controlled analgesia compared to spinal-epidural anaesthesia/analgesia,Hong Kong Med J 12 442 -7

[20] IzardJP,SoweryRD,JaegerMT,SiemensDR, 2006.Parameters affecting urologic complications after major joint replacement surgery,Can J Urol 13 3158 -63

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