Management of bladder volumes when using neuraxial anesthesia.
The major principles of management of bladder function during outpatient neuraxial blockade include choice of short-acting local anesthetics, avoidance of adding epinephrine, and reasonable fluid administration (750 to 1000 mL) to avoid overdistention of the bladder. Data suggest that low-risk patients are at no greater risk of retention than after general anesthesia, and may be discharged home with similar instructions regarding return if unable to void. High-risk patients may require closer monitoring with a BUS, and catheter drainage if volumes exceed 600 mL.
Virginia Mason Medical Center, Seattle, Washington 98101, USA. michael.mulroy@vmmc.org
Michael F
MF
Mulroy
Elizabeth A
EA
Alley
D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods; D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects; D009407:Nerve Block / Q000009:adverse effects / Q000379:methods; D011343:Procaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D016055:Urinary Retention / Q000209:etiology* / Q000517:prevention & control
D000779:Anesthetics, Local; D011343:Procaine; C004616:chloroprocaine; D008012:Lidocaine; D002045:Bupivacaine