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BJA Advance Access published online on July 1, 2006
British Journal of Anaesthesia, doi:10.1093/bja/ael172
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted May 30, 2006

Clinical Investigation

The effect of epidural sufentanil in ropivacaine on urinary retention in patients undergoing gastrectomy

J. Y. Kim 1, S. J. Lee 2, B. N. Koo 2 *, S. H. Noh 3, H. K. Kil 2, H. S. Kim 1, and S. Y. Ban 4

1 Department of Anaesthesiology and Pain Medicine, Gachon Medical School Gil Medical Center, Incheon, South Korea
2 Department of Anaesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea; Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea
3 Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
4 Department of Anaesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea

* To whom correspondence should be addressed.
B. N. Koo, E-mail: koobn{at}yumc.yonsei.ac.kr


  Abstract

Background. Although epidural opioids have excellent analgesic property, their side-effects limit its use in patient-controlled epidural analgesia (PCEA). This study was designed to compare side-effects of epidural sufentanil in ropivacaine with that of morphine in ropivacaine focusing on lower urinary tract function after major abdominal surgery.

Methods. In total 60 patients undergoing gastrectomy were randomly allocated to receive either sufentanil in ropivacaine (Group S, n=30) or morphine in ropivacaine (Group M, n=30) for their PCEA. Epidural catheter was inserted between the 7th and 8th thoracic spine. Visual analogue pain score and side-effects such as nausea, vomiting, pruritus, hypotension and urinary retention were evaluated during postoperative days (PODs) 1 and 2 in the postanaesthetic care unit.

Results. The incidence of serious to major micturition problem in Group S was lower than that in Group M (P<0.001). The incidence of pruritus, nausea and vomiting was also lower in Group S than in Group M on POD 1.

Conclusions. The lower incidence of major/serious micturition problem in patients receiving sufentanil in ropivacaine thoracic epidural analgesia suggests that continuation of urinary drainage may not be necessary from POD 1 onwards.

Keywords: analgesics opioid, morphine; analgesic opioid, sufentanil; kidney, urine; surgery, gastrointestinal.
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