International Journal of Obstetric Anesthesia
Volume 15, Issue 3 , Pages 206-211 , July 2006

Patient-controlled epidural analgesia: the role of epidural fentanyl in peripartum urinary retention

  • S. Evron

      Affiliations

    • Obstetric Anesthesia Unit, Department of Anesthesia and Department of Obstetrics & Gynecology, The Edith Wolfson Medical Center, Holon, affiliated to the Sackler Faculty of Medicine, Tel Aviv University
    • Department of Obstetrics & Gynecology, The Edith Wolfson Medical Center, Holon, affiliated to the Sackler Faculty of Medicine, Tel Aviv University
    • Department of Anesthesiology and Pharmacology, University of Louisville, Louisville, KY, USA
    • Outcomes ResearchTM Institute, Louisville, KY, USA
    • ,
  • G. Muzikant

      Affiliations

    • Obstetric Anesthesia Unit, Department of Anesthesia and Department of Obstetrics & Gynecology, The Edith Wolfson Medical Center, Holon, affiliated to the Sackler Faculty of Medicine, Tel Aviv University
    • ,
  • N. Rigini

      Affiliations

    • Obstetric Anesthesia Unit, Department of Anesthesia and Department of Obstetrics & Gynecology, The Edith Wolfson Medical Center, Holon, affiliated to the Sackler Faculty of Medicine, Tel Aviv University
    • ,
  • V. Khazin

      Affiliations

    • Obstetric Anesthesia Unit, Department of Anesthesia and Department of Obstetrics & Gynecology, The Edith Wolfson Medical Center, Holon, affiliated to the Sackler Faculty of Medicine, Tel Aviv University
    • ,
  • D.I. Sessler

      Affiliations

    • Department of Anesthesiology and Pharmacology, University of Louisville, Louisville, KY, USA
    • Outcomes ResearchTM Institute, Louisville, KY, USA
    • ,
  • O. Sadan

      Affiliations

    • Department of Obstetrics & Gynecology, The Edith Wolfson Medical Center, Holon, affiliated to the Sackler Faculty of Medicine, Tel Aviv University
    • ,
  • T. Ezri

      Affiliations

    • Obstetric Anesthesia Unit, Department of Anesthesia and Department of Obstetrics & Gynecology, The Edith Wolfson Medical Center, Holon, affiliated to the Sackler Faculty of Medicine, Tel Aviv University
    • Outcomes ResearchTM Institute, Louisville, KY, USA
    • Corresponding Author InformationCorrespondence to: Tiberiu Ezri, MD, Head, Department of Anesthesia, Wolfson Medical Center, Holon, 58100, Israel. Tel.: +972 3 5028229; fax: +972 3 5028218.
    web address

,Accepted 27 October 2005.

References 

  1. Liang CC, Wong SY, Tsay PT, et al. The effect of epidural analgesia on post-partum urinary retention in women who deliver vaginally. Int J Obstet Anesth. 2002;11:164–169
  2. Iosif S, Ingemarsson I, Ulmsten U. Urodynamic studies in normal pregnancy and puerperium. Am J Obstet Gynecol. 1980;137:696–700
  3. O’Grady F, Cattel WR. Kinetics of urinary tract infection II. The bladder. Br J Urol. 1966;38:156–162
  4. Hinman F. Postoperative overdistension of the bladder (Editorial). Surg Gynecol Obstet. 1976;142:901–902
  5. Howell CJ, Kidd C, Roberts W, et al. A randomised controlled trial of epidural compared with non-epidural analgesia in labour. Br J Obstet Gynaecol. 2001;108:27–33
  6. Crawford JS. Lumbar epidural block in labour. A clinical analysis. Br J Anaesth. 1972;44:66–74
  7. Evron S, Samueloff A, Simon A, Drenger B, Magora F. Urinary function during epidural analgesia with methadone and morphine in post-cesarean section patients. Pain. 1985;23:135–144
  8. Yip SK, Brieger G, Hin LY, Chung T. Urinary retention in the post-partum period. The relationship between obstetric factors and the post-partum post-void residual bladder volume. Acta Obstet Gynecol Scand. 1997;76:667–672
  9. Andolf E, Iosif CS, Jorgensen C, Rydhstrom H. Insidious urinary retention after vaginal delivery: Prevalence and symptoms at follow-up in a population-based study. Gynecol Obstet Invest. 1994;38:51–53
  10. Jain S, Arya VK, Gopalan S, Jain V. Analgesic efficacy of intramuscular opioids versus epidural analgesia in labor. Int J Gynecol Obstet. 2003;83:19–27
  11. Herpolsheimer A, Schretenthaler J. The use of intrapartum intrathecal narcotic analgesia in a community-based hospital. Obstet Gynecol. 1994;84:931–936
  12. Cohen SE, Yeh JY, Riley ET, Vogel TM. Walking with labor epidural analgesia: the impact of bupivacaine concentration and a lidocaine-epinephrine test dose. Anesthesiology. 2000;92:387–392
  13. Abouleish E, Rawal N, Shaw J. Intrathecal morphine 0.2 mg versus epidural bupivacaine 0.25% or their combination: effects on parturients. Anesthesiology. 1991;74:711–716
  14. Yip SK, Sahota D, Pang MW, Chang A. Post-partum urinary retention. Acta Obstet Gynecol Scand. 2004;83:881–891
  15. Gyampoh B, Crouch N, O’Brien P, O’Sullivan C, Cutner A. Intrapartum ultrasound estimation of total bladder volume. Br J Obstet Gynaecol. 2004;111:103–108
  16. Weissman A, Grisaru D, Shenhav M, Peyser RM, Jaffa AJ. Post-partum surveillance of urinary retention by ultrasonography: the effect of epidural analgesia. Ultrasound Obstet Gynecol. 1995;6:130–134
  17. Cardozo L, Tapp AJS, Wise B. Ultrasonography of the lower urinary tract. In:  Cherremak FA,  Isacson GC,  Campbel S editor. Ultrasound in obstetrics and gynecology. Boston: Little Brown; 1993;p. 1675–1677
  18. Smith NK, Morrant JD. Post-operative urinary retention in women: management by intermittent catheterization. Age Ageing. 1990;19:337–340
  19. Anderson J, Grant J. Postoperative retention of urine: a prospective urodynamic study. BMJ. 1991;302:894–896
  20. Yip SK, Sahota D, Chang A, Chung TK. Four-year follow-up of women who were diagnosed to have post-partum urinary retention. Am J Obstet Gynecol. 2002;187:648–652
  21. Evron S, Glezerman M, Sadan O, Boaz M, Ezri T. Patient-controlled epidural analgesia for labor pain: effect on labor, delivery and neonatal outcome of 0.125% bupivacaine vs 0.2% ropivacaine. Int J Obstet Anesth. 2004;13:5–10
  22. Weil A, Reyes H, Rottenberg RD, Beguin F, Herrmann WL. Effect of lumbar epidural analgesia on lower urinary tract function in the immediate post-partum period. Br J Obstet Gynaecol. 1983;90:428–432
  23. Younis MN, Abdel-Rahman FM, Khalaf I, Hablas R, Hamed AF. Bacteriuria following vaginal delivery. Int J Gynaecol Obstet. 1983;21:477–479
  24. Holms JH. Ultrasonic studies of the bladder. J Urol. 1967;97:654–663
  25. Lose G, Jorgensen L, Mortensen SO, Molsted-Pedersen L, Kristensen JK. Voiding difficulties after colposuspension. Obstet Gynecol. 1987;69:33–38
  26. Stanton SL, Ozsoy C, Hilton P. Voiding difficulties in the female: prevalence, clinical and urodynamic review. Obstet Gynecol. 1983;61:144–147

☆ Supported by NIH Grant GM 061655 (Bethesda, MD), the Gheens Foundation (Louisville, KY), the Joseph Drown Foundation (Los Angeles, CA), and the Commonwealth of Kentucky Research Challenge Trust Fund (Louisville, KY). None of the authors has any personal financial interests related to this work.

PII: S0959-289X(06)00010-0

doi: 10.1016/j.ijoa.2005.10.019

International Journal of Obstetric Anesthesia
Volume 15, Issue 3 , Pages 206-211 , July 2006

Article Tools

* Image Usage & Resolution