Post-partum urinary retention: a comparison between two methods of epidural analgesia

Objective: To compare two methods of epidural labor analgesia regarding the incidence of post-partum urinary retention. Study design: One thousand parturients who requested epidural analgesia for the relief of labor pain received, at random, either bupivacaine 0.25% with adrenaline 1:200 000 ( n = 5...

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Bibliographic Details
Published in:	European journal of obstetrics & gynecology and reproductive biology Vol. 71; no. 1; pp. 31 - 34
Main Authors:	Olofsson, Christina I.J., Ekblom, Anders O.A., Ekman-Ordeberg, Gunvor E., Irestedt, Lars E.
Format:	Journal Article
Language:	English
Published:	Shannon Elsevier Ireland Ltd 1997 Elsevier
Subjects:	Adult Analgesia, Epidural - adverse effects Analgesia, Epidural - methods Analgesia, Obstetrical - adverse effects Analgesia, Obstetrical - methods Biological and medical sciences Bupivacaine Bupivacaine - administration & dosage Bupivacaine - adverse effects Drug toxicity and drugs side effects treatment Epidural anesthesia Epinephrine - administration & dosage Epinephrine - adverse effects Female Humans Labor, Obstetric Medical sciences Pharmacology. Drug treatments Postpartum Pregnancy Puerperal Disorders - chemically induced Sufentanil Sufentanil - administration & dosage Sufentanil - adverse effects Toxicity: urogenital system Urinary retention Urinary Retention - chemically induced Bupivacaine Urinary retention Epidural anesthesia Sufentanil Postpartum Human Urinary system disease Toxicity Opiates Method Puerperium Local anesthetic Puerperal disorders Voiding dysfunction Analgesia Chemotherapy Extradural administration Complication Female Anilide Comparative study
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Summary:	Objective: To compare two methods of epidural labor analgesia regarding the incidence of post-partum urinary retention. Study design: One thousand parturients who requested epidural analgesia for the relief of labor pain received, at random, either bupivacaine 0.25% with adrenaline 1:200 000 ( n = 500) or bupivacaine 0.125% with 10 μg sufentanil ( n = 500). During the same observation period all women with clinically significant urinary retention (> 500 ml, requiring indwelling catheter) were registered. Result: Altogether 30 3.364 parturients had clinically significant urinary retention. Twenty-seven of these had received epidural analgesia (EDA) (17 with bupivacaine/adrenaline and ten with bupivacaine/sufentanil, a non-significant differences). The number of parturients with urinary retention was highly increased following EDA ( 27 1000 ) as compared to those not receiving EDA ( 3 2364 ), P < 0.001 (Fisher's exact test). In patients with EDA and urinary retention there were no difference between the groups in the incidence of instrumental deliveries or vaginal/perirectal tears. All parturients regained normal bladder function. Conclusion: EDA significantly increased the risk of post-partum urinary retention but no difference was found between the two epidural techniques.
ISSN:	0301-2115 1872-7654
DOI:	10.1016/S0301-2115(96)02610-3