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

• 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
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/S0301-2115(96)02610-3

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.