The effect of epidural sufentanil in ropivacaine on urinary retention in patients undergoing gastrectomy.
BACKGROUND
Although epidural opioids have excellent analgesic property, their side-effects limit its use in patient-controlled epidural analgesia (PCEA). This study was designed to compare side-effects of epidural sufentanil in ropivacaine with that of morphine in ropivacaine focusing on lower urinary tract function after major abdominal surgery.


METHODS
In total 60 patients undergoing gastrectomy were randomly allocated to receive either sufentanil in ropivacaine (Group S, n=30) or morphine in ropivacaine (Group M, n=30) for their PCEA. Epidural catheter was inserted between the 7th and 8th thoracic spine. Visual analogue pain score and side-effects such as nausea, vomiting, pruritus, hypotension and urinary retention were evaluated during postoperative days (PODs) 1 and 2 in the postanaesthetic care unit.


RESULTS
The incidence of serious to major micturition problem in Group S was lower than that in Group M (P<0.001). The incidence of pruritus, nausea and vomiting was also lower in Group S than in Group M on POD 1.


CONCLUSIONS
The lower incidence of major/serious micturition problem in patients receiving sufentanil in ropivacaine thoracic epidural analgesia suggests that continuation of urinary drainage may not be necessary from POD 1 onwards.
Kim
J Y
JY
Department of Anaesthesiology and Pain Medicine, Gachon Medical School Gil Medical Center Incheon, South Korea.
Lee
S J
SJ
Koo
B N
BN
Noh
S H
SH
Kil
H K
HK
Kim
H S
HS
Ban
S Y
SY
D000368:Aged; D000577:Amides; D015360:Analgesia, Epidural / Q000009:adverse effects* / Q000379:methods; D000701:Analgesics, Opioid / Q000009:adverse effects*; D000779:Anesthetics, Local; D004311:Double-Blind Method; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications; D011184:Postoperative Period; D000077212:Ropivacaine; D017409:Sufentanil / Q000009:adverse effects*; D014546:Urinary Catheterization; D016055:Urinary Retention / Q000139:chemically induced* / Q000628:therapy
D000577:Amides; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D009020:Morphine; D000077212:Ropivacaine; D017409:Sufentanil