Walking reduces the post-void residual volume in parturients with epidural analgesia for labor: a randomized-controlled study.
BACKGROUND
The post-void residual volume is higher among parturients who received epidural analgesia than those who received no or alternative analgesia.


METHODS
This prospective, randomized, controlled, non-blinded study was performed in a tertiary referral center labor suite. The post-void residual volume was measured by a transabdominal ultrasound following a voiding attempt. Healthy parturients with low-dose epidural analgesia in active labor were randomized either to walk to the toilet or to use a bedpan for voiding. The primary outcome measure (post-void residual volume in labor) was compared between the study groups.


RESULTS
The toilet group (n=34) and the bedpan group (n=28) demonstrated similar post-void residual volumes (212 +/- 100 vs. 168 +/- 93 ml, P=0.289). Twenty patients (59%) randomized to the toilet group were unable to walk and actually voided in a bedpan. A secondary analysis was performed analyzing the groups as treated. The post-void residual volume was significantly lower in the actual toilet group (n=14, 63 +/- 24 ml) vs. the bedpan group (n=48, 229 +/- 200 ml), P=0.0052. Thirteen (93%) women who walked to the toilet managed to void before the ultrasound measurement vs. 20/48 (42%) using the bedpan, P=0.001. Fewer women who managed to walk to the toilet required urinary bladder catheterization during the labor than women who used the bedpan (6/14, 43% vs. 36/48, 75%) P=0.028.


CONCLUSIONS
Women who were randomized to walk to the bathroom with epidural analgesia and were able to do so during labor had a significantly reduced post-void residual volume and a reduced requirement for urinary catheterization.
Weiniger
C F
CF
Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, Jerusalem, Israel. carolynfweiniger@gmail.com
Yaghmour
H
H
Nadjari
M
M
Einav
S
S
Elchalal
U
U
Ginosar
Y
Y
Matot
I
I
D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D004311:Double-Blind Method; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000502:physiology; D014554:Urination / Q000502:physiology; D014563:Urodynamics / Q000502:physiology*; D016138:Walking / Q000502:physiology*