Does Thoracic Epidural Analgesia Influence Urinary Micturition by Patients Undergoing Thoracic Surgery?

NCT00976313 | Completed

• 1 other identifier: 171/09
• Study Type: observational
• Target: 26
• Locations: 1 country
• Sites: 1

Brief Summary

Under the influence of epidural analgesia, patients may not feel the urge to urinate, which can result in urinary retention and bladder overdistension. The use of a transurethral catheter is associated with significant morbidity such as patient discomfort, urinary tract infections, urethral trauma and stricture. Urodynamic changes under thoracic epidural anaesthesia are still unknown. The aim of this study is to compare lower urinary tract function before and during thoracic epidural analgesia within segments T2 to T10 for postoperative pain treatment in patients undergoing thoracotomy or sternotomy.

Conditions

Thoracotomy; Sternotomy

Keywords

thoracic epidural analgesia; urinary micturition; thoracotomy

Outcome Measures

Primary Outcomes (1)

• Differences in postvoid residual urine volume before and during thoracic epidural analgesia

  3 days

Secondary Outcomes (3)

• Voided volume

  3 days

• Maximum bladder capacity

  3 days

• Bladder sensitivity (yes/no) at strong desire to void

  3 days

Study Arms (2)

1

male patients

Procedure: Assessment of urinary micturition after thoracotomy; Other: International Prostate Symptom Score

2

female patients

Procedure: Assessment of urinary micturition after thoracotomy; Other: International Prostate Symptom Score

Interventions

Assessment of urinary micturition after thoracotomy PROCEDURE

Post residual urine volume and voided volume will be assessed with Bladder Scan™ BVI 6100 (Bladder scan, Bothell, WA, USA) will be performed the day before surgery and on day 2 after surgery, with epidural analgesia within segments T2-4 to T10 21,22. Bladder sensitivity will be assessed at strong desire to void. On day 2 the bladder will be filled through the transurethral catheter till the patient signalised a strong desire to void, then the catheter will be removed and spontaneous micturition will be attempted. Voided volume and post void residual will be assessed.

1; 2

International Prostate Symptom Score OTHER

International Prostate Symptom Score (IPSS) for assessment of lower urinary tract symptoms (LUTS) preoperatively

1; 2

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

male and female patients undergoing thoracotomy or sternotomy

You may qualify if:

• Written informed consent
• Thoracic surgery including thoracotomy and sternotomy
• Thoracic epidural analgesia

You may not qualify if:

• Contraindications to epidural anesthesia or refusal
• Preoperative residual urine volume \> 100ml
• International Prostate Symptom Score (IPSS) \> 7
• Pregnancy

Sponsors & Collaborators

• Insel Gruppe AG, University Hospital Bern: lead

Study Sites (1)

Dep of anesthesiology and pain treatment, Bern University Hospital

Bern, 3010, Switzerland

Location

Related Publications (6)

• Appell RA, England HR, Hussell AR, McGuire EJ. The effects of epidural anesthesia on the urethral closure pressure profile in patients with prostatic enlargement. J Urol. 1980 Sep;124(3):410-1. doi: 10.1016/s0022-5347(17)55474-9.

  PMID: 6159487 BACKGROUND

• Kau YC, Lee YH, Li JY, Chen C, Wong SY, Wong TK. Epidural anesthesia does not increase the incidences of urinary retention and hesitancy in micturition after ambulatory hemorrhoidectomy. Acta Anaesthesiol Sin. 2003 Jun;41(2):61-4.

  PMID: 12934418 BACKGROUND

• Weiniger CF, Wand S, Nadjari M, Elchalal U, Mankuta D, Ginosar Y, Matot I. Post-void residual volume in labor: a prospective study comparing parturients with and without epidural analgesia. Acta Anaesthesiol Scand. 2006 Nov;50(10):1297-303. doi: 10.1111/j.1399-6576.2006.01122.x. Epub 2006 Sep 15.

  PMID: 16978160 BACKGROUND

• Axelsson K, Mollefors K, Olsson JO, Lingardh G, Widman B. Bladder function in spinal anaesthesia. Acta Anaesthesiol Scand. 1985 Apr;29(3):315-21. doi: 10.1111/j.1399-6576.1985.tb02207.x.

  PMID: 3993320 BACKGROUND

• Basse L, Werner M, Kehlet H. Is urinary drainage necessary during continuous epidural analgesia after colonic resection? Reg Anesth Pain Med. 2000 Sep-Oct;25(5):498-501. doi: 10.1053/rapm.2000.9537.

  PMID: 11009235 BACKGROUND

• Wuethrich PY, Henning A, Schweizerhof M, Kessler TM, Burkhard FC. Postvoid residuals remain unchanged in patients with postoperative thoracic epidural analgesia after thoracotomy. Reg Anesth Pain Med. 2011 Jan-Feb;36(1):46-50. doi: 10.1097/AAP.0b013e3182030828.

  PMID: 21455089 DERIVED

Study Officials

• Patrick Y Wuethrich, MD

  Dep of Anesthesiologiy and Pain treatment, University Hospital Bern, 3010 Bern, Switzerland

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER

Study Record Dates

• First Submitted: September 11, 2009
• First Posted: September 14, 2009
• Study Start: September 1, 2009
• Primary Completion: April 1, 2010
• Study Completion: April 1, 2010
• Last Updated: June 9, 2010

Record last verified: 2010-06

Locations

CH (1)