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Journal of Bone and Joint Surgery - British Volume, Vol 86-B, Issue 8,
1115-1117.
doi: 10.1302/0301-620X.86B8.14240 Copyright © 2004 by British Editorial Society of Bone and Joint Surgery Is epidural anaesthesia acceptable at total hip arthroplasty?A STUDY OF THE RATES OF URINARY CATHETERISATIONA. D. Macdowell, MA, FRCS, Trauma & Orth, Specialist Registrar in Orthopaedic Surgery1; A. H. N. Robinson, BSc, FRCS, Orth, Consultant Orthopaedic Surgeon1; D. J. Hill, MA, FRCA, Emeritus Consultant Anaesthetist2; and R. N. Villar, MA, MS, FRCS, Consultant Orthopaedic Surgeon1
1 Department of Orthopaedics Correspondence should be sent to Mr R. N. Villar at Cambridge Hip and Knee Unit, BUPA Cambridge Lea Hospital, Impington, Cambridge CB4 9EL, UK. Epidural anaesthesia, with and without opiate, is widely used in total hip arthroplasty (THA). It may cause urinary retention, leading to catheterisation, and a subsequent increase in the likelihood of deep infection. We investigated prospectively the rate of urinary catheterisation in patients after THA performed under general anaesthesia, with or without peri-operative fentanyl and bupivacaine opiate epidural anaesthesia. Of 173 patients, 75 received general anaesthesia alone and 98 both general and epidural management. The post-operative rate of catheterisation was 14.7% in those who received general anaesthesia alone and 13.3% in those who received both. Our findings suggest that the rate of post-operative urinary catheterisation does not increase when general anaesthesia is supplemented by epidural anaesthesia using fentanyl and bupivicaine.
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