Abstract：
BACKGROUND: Postpartum urinary retention is a common complication following caesarean section, with significant implications for patient comfort and recovery. Combined spinal and epidural anaesthesia is frequently employed for caesarean section, but postpartum urinary retention remains a clinical concern despite its benefits. This study aimed to investigate the effectiveness of hydromorphone hydrochloride combined with bupivacaine for combined spinal and epidural anaesthesia in reducing postpartum urinary retention.
METHODS: A retrospective analysis was conducted on patients who received combined spinal and epidural anaesthesia for caesarean section. The control group received bupivacaine, whereas the hydromorphone hydrochloride combined with bupivacaine spinal-epidural anaesthesia (HB) group received hydromorphone hydrochloride combined with bupivacaine. Data on demographics, anaesthesia, operative characteristics, postoperative urinary retention and adverse events were collected and analysed.
RESULTS: The study enrolled 105 patients, with a control group (n = 51) receiving bupivacaine spinal-epidural anaesthesia and an observation group (n = 54) receiving hydromorphone hydrochloride combined with bupivacaine spinal-epidural anaesthesia. The incidence of postoperative urinary retention was significantly lower in the HB group than in the control group (3.70% vs. 17.65%, p = 0.044). Furthermore, the HB group exhibited a shorter time to first voiding after anaesthesia (5.72 ± 1.26 h vs. 6.28 ± 1.35 h, p = 0.029), lower peak postvoid residual volume (168.57 ± 25.09 mL vs. 180.43 ± 30.21 mL, p = 0.032), decreased need for postoperative catheterisation (5.56% vs. 21.57%, p = 0.034) and shorter duration of urinary catheterisation (10.92 ± 2.61 h vs. 12.04 ± 2.87 h, p = 0.039) than the control group. Correlation analysis supported a negative correlation between hydromorphone supplementation and parameters related to postoperative urinary retention. Multivariate regression analysis demonstrated a significant association between the duration of urinary catheterisation and the use of hydromorphone with the occurrence of postoperative urinary retention, providing further insights into the multifactorial nature of this postoperative complication.
CONCLUSIONS: The addition of hydromorphone hydrochloride to bupivacaine for combined spinal and epidural anaesthesia was associated with a reduced incidence of postpartum urinary retention and improved postoperative voiding parameters, without significantly increasing the risk of adverse events.
METHODS: A retrospective analysis was conducted on patients who received combined spinal and epidural anaesthesia for caesarean section. The control group received bupivacaine, whereas the hydromorphone hydrochloride combined with bupivacaine spinal-epidural anaesthesia (HB) group received hydromorphone hydrochloride combined with bupivacaine. Data on demographics, anaesthesia, operative characteristics, postoperative urinary retention and adverse events were collected and analysed.
RESULTS: The study enrolled 105 patients, with a control group (n = 51) receiving bupivacaine spinal-epidural anaesthesia and an observation group (n = 54) receiving hydromorphone hydrochloride combined with bupivacaine spinal-epidural anaesthesia. The incidence of postoperative urinary retention was significantly lower in the HB group than in the control group (3.70% vs. 17.65%, p = 0.044). Furthermore, the HB group exhibited a shorter time to first voiding after anaesthesia (5.72 ± 1.26 h vs. 6.28 ± 1.35 h, p = 0.029), lower peak postvoid residual volume (168.57 ± 25.09 mL vs. 180.43 ± 30.21 mL, p = 0.032), decreased need for postoperative catheterisation (5.56% vs. 21.57%, p = 0.034) and shorter duration of urinary catheterisation (10.92 ± 2.61 h vs. 12.04 ± 2.87 h, p = 0.039) than the control group. Correlation analysis supported a negative correlation between hydromorphone supplementation and parameters related to postoperative urinary retention. Multivariate regression analysis demonstrated a significant association between the duration of urinary catheterisation and the use of hydromorphone with the occurrence of postoperative urinary retention, providing further insights into the multifactorial nature of this postoperative complication.
CONCLUSIONS: The addition of hydromorphone hydrochloride to bupivacaine for combined spinal and epidural anaesthesia was associated with a reduced incidence of postpartum urinary retention and improved postoperative voiding parameters, without significantly increasing the risk of adverse events.
摘要：
背景：产后尿潴留是剖宫产术后常见的并发症，对患者的舒适度和康复具有重要意义。腰麻和硬膜外联合麻醉经常用于剖腹产，但产后尿潴留仍然是一个临床问题，尽管它的好处。本研究旨在探讨盐酸氢吗啡酮联合布比卡因用于腰硬联合麻醉减少产后尿潴留的效果。
方法：对接受腰硬联合麻醉的剖宫产患者进行回顾性分析。对照组给予布比卡因,而盐酸氢吗啡酮联合布比卡因腰麻-硬膜外麻醉（HB）组接受盐酸氢吗啡酮联合布比卡因。人口统计数据，麻醉,手术特征，收集并分析术后尿潴留和不良事件.
结果：该研究招募了105名患者，对照组（n=51）接受布比卡因腰麻-硬膜外麻醉，观察组（n=54）接受盐酸氢吗啡酮联合布比卡因腰麻-硬膜外麻醉。HB组术后尿潴留的发生率明显低于对照组(3.70%vs.17.65%,p=0.044)。此外，HB组麻醉后首次排尿时间较短(5.72±1.26hvs.6.28±1.35h,p=0.029),较低的峰值后空隙残留量(168.57±25.09毫升与180.43±30.21mL,p=0.032),术后导管插入的需求减少(5.56%vs.21.57%,p=0.034)和更短的导尿持续时间(10.92±2.61hvs.12.04±2.87h,p=0.039）比对照组。相关分析支持补充氢吗啡酮与术后尿潴留相关参数之间呈负相关。多因素回归分析表明，导尿时间和氢吗啡酮的使用与术后尿潴留的发生之间存在显着关联。提供对这种术后并发症的多因素性质的进一步见解。
结论：在腰硬联合麻醉中布比卡因中加入盐酸氢吗啡酮与降低产后尿潴留的发生率和改善术后排尿参数有关。而不会显著增加不良事件的风险。
方法：对接受腰硬联合麻醉的剖宫产患者进行回顾性分析。对照组给予布比卡因,而盐酸氢吗啡酮联合布比卡因腰麻-硬膜外麻醉（HB）组接受盐酸氢吗啡酮联合布比卡因。人口统计数据，麻醉,手术特征，收集并分析术后尿潴留和不良事件.
结果：该研究招募了105名患者，对照组（n=51）接受布比卡因腰麻-硬膜外麻醉，观察组（n=54）接受盐酸氢吗啡酮联合布比卡因腰麻-硬膜外麻醉。HB组术后尿潴留的发生率明显低于对照组(3.70%vs.17.65%,p=0.044)。此外，HB组麻醉后首次排尿时间较短(5.72±1.26hvs.6.28±1.35h,p=0.029),较低的峰值后空隙残留量(168.57±25.09毫升与180.43±30.21mL,p=0.032),术后导管插入的需求减少(5.56%vs.21.57%,p=0.034)和更短的导尿持续时间(10.92±2.61hvs.12.04±2.87h,p=0.039）比对照组。相关分析支持补充氢吗啡酮与术后尿潴留相关参数之间呈负相关。多因素回归分析表明，导尿时间和氢吗啡酮的使用与术后尿潴留的发生之间存在显着关联。提供对这种术后并发症的多因素性质的进一步见解。
结论：在腰硬联合麻醉中布比卡因中加入盐酸氢吗啡酮与降低产后尿潴留的发生率和改善术后排尿参数有关。而不会显著增加不良事件的风险。
