POST-OPERATIVE URINARY RETENTION AFTER SPINAL ANESTHESIA IN HERNIA SURGERY: A PROSPECTIVE, COMPARATIVE DOUBLE-BLIND STUDY BETWEEN ROPIVACAINE HEAVY 0.75% AND BUPIVACAINE HEAVY 0.5%

Abstract

Objective: The objective of this study was to evaluate and compare the effect of spinal anesthesia (SA) with bupivacaine and ropivacaine on recovery of bladder function and time of ambulation in healthy men who were scheduled for hernia surgery. Methods: In this double-blind study, 60 patients of the American Society of Anesthesiologists I/II/III were assigned to Group B (bupivacaine)/Group R (ropivacaine). Before SA, ultrasonography-guided bladder volume was measured. After the operation, bladder volume was measured continuously every 2 hourly until the patient could void urine spontaneously or need of catheterization. Motor blockade and time of ambulation were recorded. Results: Bromage scale at 4 h was significantly higher (p=0.0001) in ropivacaine showing intrathecal ropivacaine 3.5 mL produce shorter motor blockade then 3.5 mL bupivacaine. Both Group R and Group B were comparable in terms of ability to void urine (p>0.05), time to complete ambulation without support (p>0.05), and time to negative Romberg test (p>0.05). Negative correlation was found between the first spontaneous void urine and the modified Bromage scale. Conclusions: After SA with bupivacaine, only two patients developed post-operative urinary retention and none in the ropivacaine. However, Group R required lesser time to void and early recovery of motor function. The time to first void urine was more than the time for complete ambulation (1–3.5 h after ambulation).