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Epidural anaesthesia in total hip replacement is an established and safe practice. It may be used alone or in combination with general anaesthesia for analgesia. Urethral catheterization in the perioperative period is known to greatly increase the complication of deep sepsis following total hip replacement. We assessed the effect on the incidence of urinary catheterization of using bupivocaine epidural anaesthesia in addition to general anaesthesia in total hip replacement. A prospective study was made of 113 total hip replacements. The incidence of catheterization in male patients who received an epidural was 67% compared to only 12% who had no epidural [P = 0.001]. In women the corresponding rates were 30% and 23%. We conclude that in men the use of supplementary epidural anaesthesia with bupivocaine is associated with a worrying increased need for urinary catheterization. This must be balanced against the claimed benefits of this form of anaesthesia.

Type

Journal article

Journal

Journal of the Royal Society of Medicine

Publication Date

12/1995

Volume

88

Pages

699p - 701p

Addresses

Royal National Orthopaedic Hospital, Middlesex, England.

Keywords

Humans, Bacteriuria, Urinary Retention, Urinary Catheterization, Anesthesia, Epidural, Risk Factors, Prospective Studies, Hip Prosthesis, Adult, Aged, Aged, 80 and over, Middle Aged, Female, Male