Spinal anesthesia: should everyone receive a urinary catheter?: a randomized, prospective study of patients undergoing total hip arthroplasty.

Authors

Adam G Miller, MD, Rothman Institute, Thomas Jefferson University HospitalFollow
James McKenzie, BS, Rothman Institute, Thomas Jefferson University HospitalFollow
Max Greenky, BA, Rothman Institute, Thomas Jefferson University HospitalFollow
Erica Shaw, RNP, Rothman Institute, Thomas Jefferson University Hospital
Kishor Gandhi, MD, Rothman Institute, Thomas Jefferson University HospitalFollow
William J Hozack, MD, Rothman Institute at Thomas Jefferson UniversityFollow
Javad Parvizi, MD, FRCS, Rothman Institute at Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

8-21-2013

Comments

This article has been peer reviewed. It is the authors' final version prior to publication in The Journal of bone and joint surgery. American volume.

Volume 95, Issue 16, August 21, 2013, Pages 1498-1503.

The published version is available at DOI: 10.2106/JBJS.K.01671. Copyright © STRIATUS Orthopaedic Communications

Abstract

BACKGROUND: The objective of this randomized prospective study was to determine whether a urinary catheter is necessary for all patients undergoing total hip arthroplasty under spinal anesthesia.

METHODS: Consecutive patients undergoing total hip arthroplasty under spinal anesthesia were randomized to treatment with or without insertion of an indwelling urinary catheter. All patients received spinal anesthesia with 15 to 30 mg of 0.5% bupivacaine. The catheter group was subjected to a standard postoperative protocol, with removal of the indwelling catheter within forty-eight hours postoperatively. The experimental group was monitored for urinary retention and, if necessary, had straight catheterization up to two times prior to the placement of an indwelling catheter.

RESULTS: Two hundred patients were included in the study. There was no significant difference between the two groups in terms of the prevalence of urinary retention, the prevalence of urinary tract infection, or the length of stay. Nine patients in the no-catheter group and three patients in the catheter group (following removal of the catheter) required straight catheterization because of urinary retention. Three patients in the catheter group and no patient in the no-catheter group had development of urinary tract infection.

CONCLUSIONS: Patients undergoing total hip arthroplasty under spinal anesthesia appear to be at low risk for urinary retention. Thus, a routine indwelling catheter is not required for such patients.

Recommended Citation

Miller, MD, Adam G; McKenzie, BS, James; Greenky, BA, Max; Shaw, RNP, Erica; Gandhi, MD, Kishor; Hozack, MD, William J; and Parvizi, MD, FRCS, Javad, "Spinal anesthesia: should everyone receive a urinary catheter?: a randomized, prospective study of patients undergoing total hip arthroplasty." (2013). Rothman Institute Faculty Papers. Paper 52.
https://jdc.jefferson.edu/rothman_institute/52