Luger et al monitored urinary retention in patients undergoing knee arthroscopic surgery. They developed criteria for catheterization of a patient in the perioperative period. The authors are from Innsbrook Medical University in Austria.
Patient selection: knee arthroscopic surgery using low-dose spinal anesthesia (1.4 mL of 0.5% bupivcaine at level L3/L4), able to spontaneously void urine
Patient monitoring: ultrasound scanner for bladder volume (BladderScan BVI 3000)
Parameters:
(1) operative status
(2) bladder volume in mL
(3) ability to void spontaneously
(4) residual bladder volume after voiding in mL
|
Operative Status |
Bladder Volume |
Spontaneous Voiding |
Volume After Voiding |
Catheterize? |
|
preop |
< 100 mL |
NA |
NA |
no |
|
preop |
>= 100 mL |
yes |
< 100 |
no |
|
preop |
>= 100 mL |
yes |
>= 100 |
yes |
|
preop |
>= 100 mL |
no |
NA |
yes |
|
immediate postop |
< 300 mL |
NA |
NA |
no |
|
immediate postop |
>= 300 mL |
NA |
NA |
yes |
|
after on ward |
< 500 mL |
yes |
NA |
no |
|
after on ward |
>= 500 mL |
no |
NA |
yes |
|
after on ward |
>= 500 mL |
yes |
< 500 |
possibly (monitor) |
|
after on ward |
>= 500 mL |
yes |
>= 500 |
yes |
where:
• The patient was monitored on a hospital ward after surgery until all discharge criteria were met. Monitoring was done for up to 4 hours after surgery.
• Overdistention of the urinary bladder may be complicated by impaired bladder contraction.
Specialty: Anesthesiology, Nephrology
