Structured Abstract
Objective: To assess whether the non-placement or early removal
of urinary catheter (Ucath) could improve the recovery of patients
undergoing cesarean delivery (CD). Moreover, we assessed the impact of
neuraxial morphine in this study population.
Design : Prospective cohort
Setting: Hospital ClĂnic of Barcelona.
Sample Patients undergoing CD
Methods: Prospective cohort over a 10-month period.
Main outcomes measures : Surgical time (ST), time to first
spontaneous micturition (FSM), need for intermittent catheterization
(Icath), time to first solid oral intake (FOI), time to mobilization
(Tmob) and time to hospital discharge (THD).
Results . Among 290 patients, those without or who had Ucath
removed early (first 6h) displayed significantly shorter times to: FSM,
FOI, Tmob and THD. Urinary retention (21.9 % vs 8.9 %, p = 0.004) and
intermitent catheterization (39.7 % vs 19.6 %, p < 0.001)
were more frequent when Ucath was not placed. Using morphine did not
significantly increase postoperative times. Urinary retention was
significantly higher when morphine was used in spinal anesthesia (8.7 %
vs 21.8 %, p = 0.049). No differences were found in terms of nausea,
vomiting and pruritus. Morphine was associated with better pain control
at 6 and 12 h at rest.
Conclusions . Not using or removing Ucath early had a positive
impact on the postoperative care of CD. Neuraxial morphine was
appropriate and safe and should be considered a first-line analgesic in
CD.
Fundings. This study did not receive financial support.
Keywords Enhanced recovery after surgery, urinary catheter,
cesarean delivery, morphine, neuraxial anesthesia.
Tweetable abstract: Not using or removing urinary
catheters early had a positive impact on the care of cesarean delivery
patients