Timing of Catheter Removal and Effect on Urinary Retention After Cesarean Birth

IF 1.8 4区医学 Q2 NURSING

Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing Pub Date : 2024-11-01 DOI:10.1016/j.jogn.2024.05.138

Corie Hoskins, Amy Dempsey, Karen Kaley, Lina Brou

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引用次数: 0

Abstract

Objective

To determine the association between timing of indwelling catheter removal and urinary retention after cesarean.

Design

Retrospective cohort study.

Setting

Eight hospitals in suburban, rural, and urban Colorado and Montana.

Participants

Women who gave birth by cesarean from January 1, 2021 to April 30, 2022 (N = 3,493).

Methods

We categorized participants who gave birth between January 1, 2021 and June 30, 2021 (before implementation of the Enhanced Recovery After Surgery initiative) into Group A and participants who gave birth between July 1, 2021 and April 30, 2022 (after implementation of the Enhanced Recovery After Surgery initiative) into Group B. We used descriptive statistics to report the proportion of participants in both groups who experienced urinary retention after birth. We performed chi-square tests to determine the association between the time of catheter removal and incidence of urinary retention. We used the Wilcoxon rank sum test to determine the association between length of stay and urinary retention.

Results

Urinary retention rates were 5.8% in Group A and 12.6% in Group B (p < .001). In both groups, participants who received epidural anesthesia experienced significantly more urinary retention than those who received spinal anesthesia (p < .001). Participants who received epidural anesthesia and experienced urinary retention pushed 16.9% longer than those without urinary retention (p < .001). The proportion of participants who experienced urinary retention after catheter removal was 19.4% at 7 hours, 4.6% at 16 hours, and 9.9% at 12 hours after birth. Length of stay was determined to be inconclusive.

Conclusion

We determined that the optimal time of catheter removal to minimize the rate of urinary retention was 12 to 16 hours after cesarean among women who received morphine sulfate as the anesthesia.

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拔除导尿管的时机及对剖腹产后尿潴留的影响

目的确定拔除留置导尿管的时间与剖宫产术后尿潴留之间的关系：设计：回顾性队列研究：科罗拉多州和蒙大拿州郊区、农村和城市的八家医院：方法：我们将 2021 年 1 月 1 日至 2022 年 4 月 30 日期间剖宫产的妇女（N=3496）进行分类：我们将 2021 年 1 月 1 日至 2021 年 6 月 29 日（实施 "术后强化恢复 "计划之前）分娩的参与者分为 A 组，将 2021 年 7 月 1 日至 2022 年 4 月 30 日（实施 "术后强化恢复 "计划之后）分娩的参与者分为 B 组。我们通过卡方检验来确定拔除导尿管的时间与尿潴留发生率之间的关系。我们使用 Wilcoxon 秩和检验来确定住院时间与尿潴留之间的关系：结果：A 组尿潴留率为 5.8%，B 组为 12.6%（P < .001）。在这两组中，接受硬膜外麻醉的参与者的尿潴留率明显高于接受脊髓麻醉的参与者（p < .001）。接受硬膜外麻醉并出现尿潴留的参试者比没有出现尿潴留的参试者推注时间长 16.9%（p < .001）。拔除导尿管后出现尿潴留的参试者比例在产后 7 小时为 19.4%，16 小时为 4.6%，12 小时为 9.9%。住院时间长短尚无定论：我们确定，在接受硫酸吗啡脊髓麻醉的产妇中，拔除导尿管以减少尿潴留发生率的最佳时间为剖宫产后 12 至 16 小时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Jognn-Journal of Obstetric Gynecologic and Neonatal Nursing 医学-妇产科学

CiteScore

3.20

自引率

5.60%

发文量

审稿时长

43 days

期刊介绍： JOGNN is a premier resource for health care professionals committed to clinical scholarship that advances the health care of women and newborns. With a focus on nursing practice, JOGNN addresses the latest research, practice issues, policies, opinions, and trends in the care of women, childbearing families, and newborns. This peer-reviewed scientific and technical journal is highly respected for groundbreaking articles on important - and sometimes controversial - issues. Articles published in JOGNN emphasize research evidence and clinical practice, building both science and clinical applications. JOGNN seeks clinical, policy and research manuscripts on the evidence supporting current best practice as well as developing or emerging practice trends. A balance of quantitative and qualitative research with an emphasis on biobehavioral outcome studies and intervention trials is desired. Manuscripts are welcomed on all subjects focused on the care of women, childbearing families, and newborns.