The effect of intermittent versus continuous bladder catheterization on labor duration and postpartum urinary retention and infection: a randomized trial.
OBJECTIVE
To assess the effect of intermittent versus continuous bladder catheterization on labor duration and local anesthetic consumption.


METHODS
Randomized, controlled, prospective, single-blind trial.


METHODS
University-affiliated hospital.


METHODS
209 ASA physical status I and II, primiparous parturients who received patient-controlled epidural analgesia for labor.


METHODS
Patients were randomly allocated to either the intermittent bladder catheterization group (Group IC; n = 109) or the continuous catheterization group (Group CC; n = 100).


METHODS
Duration of the second stage of labor, dose of local anesthetics given, and primary outcomes were compared by group using the t-test for independent samples. Main secondary outcomes were postpartum urinary retention and rate of postpartum urinary tract infection (UTI; asymptomatic bacteruria).


RESULTS
Duration of the second stage of labor was longer in Group CC than Group IC: 105 +/- 72 vs. 75 +/- 52 min (P = 0.002). This finding was associated with increased local anesthetic dose requirement in Group CC during both stages of labor (73 +/- 25 mL vs. 63 +/- 26 mL; P = 0.005). The rate of UTI was similar (30%) in both study groups.


CONCLUSIONS
Intermittent bladder catheterization was associated with shorter second-stage labor and less local anesthetic, but the same frequency of postpartum urinary retention and UTI was seen with both catheterization groups.
Evron
Shmuel
S
Obstetric Anesthesia Unit, Department of Anesthesia, the Edith Wolfson Medical Center, Holon, Israel.
Dimitrochenko
Vladimir
V
Khazin
Vadim
V
Sherman
Alexander
A
Sadan
Oscar
O
Boaz
Mona
M
Ezri
Tiberiu
T
D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007748:Labor Stage, Second; D007743:Labor, Obstetric; D007744:Obstetric Labor Complications / Q000209:etiology / Q000517:prevention & control; D049590:Postpartum Period; D011247:Pregnancy; D011446:Prospective Studies; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D014546:Urinary Catheterization / Q000379:methods*; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy*; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult
D000779:Anesthetics, Local