0
Cardiothoracic Surgery |

Is It Safe to Remove Urinary Catheters in General Thoracic Surgery Patients Receiving Thoracic Epidural Analgesia Within the First 24 Hours?

Laurel Rhyne*, MSN; Tiffany Potter, BSN; J. Robert Headrick, MD
Author and Funding Information

Memorial Health Care System, Chattanooga, TN


Chest. 2012;142(4_MeetingAbstracts):53A. doi:10.1378/chest.1365828
Text Size: A A A
Published online

Abstract

SESSION TYPE: Thoracic Surgery Posters I

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: In response to an identified association of prolonged urinary catheterization with urinary tract infections (UTI’s), the Centers of Disease Control established a 1b recommendation guiding postoperative removal of urinary catheters within 24 hours unless otherwise indicated. In general thoracic surgical patients receiving thoracic epidural analgesia, current practice dictates maintaining urinary catheterization for the duration of the epidural to prevent urinary retention. The purpose of this study was to evaluate urinary retention rates when urinary catheters were discontinued within the first 24 hours post-op during uninterrupted epidural analgesia.

METHODS: All general thoracic surgery patients with thoracic epidural analgesia were considered for inclusion in a prospective, observational study during a seven-month period. Exclusion occurred if patients were <18, male >65, had a history of urologic procedures or urinary retention, known benign prostatic hypertrophy, or admitted to ICU. Informed consent was obtained. Data points collected included location of epidural; time and amount of spontaneous void; urinary bladder scanning results; time of epidural discontinuation and presence of UTI defined by CDC guidelines. Urinary catheter discontinuation was scheduled for midnight on the operative day. Urinary retention was identified at >400cc determined by bladder scan. The study was Institutional Review Board approved.

RESULTS: 69 general thoracic surgery patients with thoracic epidurals were considered for study over a seven-month time period. Of those, 46 qualified. The urinary catheters of 39 patients were removed within 24 hours post-op. Seven patients did not receive a urinary catheter. SPSS was utilized for analysis. Of the 46 patients, 2% had urinary retention.

CONCLUSIONS: Urinary catheter removal within 24 hours post-op in carefully selected general thoracic surgery patients receiving uninterrupted thoracic epidural analgesia resulted in a low incidence of urinary retention.

CLINICAL IMPLICATIONS: In select populations of general thoracic surgery patients with thoracic epidurals, removal of urinary catheters is safe and complies with the CDC recommendations.

DISCLOSURE: The following authors have nothing to disclose: Laurel Rhyne, Tiffany Potter, J. Robert Headrick

No Product/Research Disclosure Information

Memorial Health Care System, Chattanooga, TN

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543