Abstract：
BACKGROUND: Cesarean deliveries (CD) are commonly performed using neuraxial anesthesia. The use of neuraxial morphine has proven beneficial in terms of postoperative pain management; however, its effect on postoperative urine retention remains unclear.
OBJECTIVE: To determine whether morphine injection into the neuraxis during CD influences postoperative urinary retention rate.
METHODS: We conducted a retrospective case-control observational study of patients undergoing CD. We compared patients using morphine injected into the intrathecal or epidural spaces (November 2020 to October 2021) to a historical cohort of patients undergoing CD without morphine (November 2019 to October 2020). The primary outcome was the rate of postoperative overt urinary retention necessitating bladder catheterization.
RESULTS: The study group comprised 283 patients, and 313 patients in the control group were eligible for analysis. No differences were found with respect to the baseline demographic and indication for CD. The number of postpartum urinary bladder catheterizations due to urine retention was higher in the study group (5% vs. 1%, P-value = 0.003). No cases of 30-day readmission were recorded. Moreover, patients treated with neuraxial morphine required fewer repeat doses of postoperative anesthesia (oral analgesia 7.4 vs. 10.1, intravenous analgesia 0.29 vs. 0.31, oral opioids 0.06 vs. 3.70, intravenous opioids 0.01 vs. 0.45, P-value < 0.001 for all).
CONCLUSIONS: While neuraxial morphine used during CD appears to be safe and effective, the risk of postoperative urinary retention seems to be increased due to its use. Cases of overt urinary retention treated by bladder catheterization does not lead to short-term complications.
OBJECTIVE: To determine whether morphine injection into the neuraxis during CD influences postoperative urinary retention rate.
METHODS: We conducted a retrospective case-control observational study of patients undergoing CD. We compared patients using morphine injected into the intrathecal or epidural spaces (November 2020 to October 2021) to a historical cohort of patients undergoing CD without morphine (November 2019 to October 2020). The primary outcome was the rate of postoperative overt urinary retention necessitating bladder catheterization.
RESULTS: The study group comprised 283 patients, and 313 patients in the control group were eligible for analysis. No differences were found with respect to the baseline demographic and indication for CD. The number of postpartum urinary bladder catheterizations due to urine retention was higher in the study group (5% vs. 1%, P-value = 0.003). No cases of 30-day readmission were recorded. Moreover, patients treated with neuraxial morphine required fewer repeat doses of postoperative anesthesia (oral analgesia 7.4 vs. 10.1, intravenous analgesia 0.29 vs. 0.31, oral opioids 0.06 vs. 3.70, intravenous opioids 0.01 vs. 0.45, P-value < 0.001 for all).
CONCLUSIONS: While neuraxial morphine used during CD appears to be safe and effective, the risk of postoperative urinary retention seems to be increased due to its use. Cases of overt urinary retention treated by bladder catheterization does not lead to short-term complications.
摘要：
背景：剖宫产（CD）通常使用神经轴麻醉进行。使用神经轴吗啡已被证明在术后疼痛管理方面是有益的;然而，其对术后尿潴留的影响尚不清楚.
目的：确定CD期间向神经轴注射吗啡是否会影响术后尿潴留率。
方法：我们对接受CD的患者进行了回顾性病例对照观察研究。我们将使用鞘内或硬膜外腔注射吗啡的患者（2020年11月至2021年10月）与无吗啡的CD患者的历史队列（2019年11月至2020年10月）进行了比较。主要结果是术后明显尿潴留的发生率，需要进行膀胱导管检查。
结果：研究组包括283名患者，对照组313例患者符合分析条件.在基线人口统计学和CD适应症方面没有发现差异。在研究组中，由于尿retention留引起的产后膀胱导尿次数较高（5％vs.1%,P值=0.003)。没有记录30天再入院的病例。此外，使用神经轴吗啡治疗的患者需要更少的术后麻醉重复剂量（口服镇痛7.4vs.10.1，静脉镇痛0.29vs.0.31，口服阿片类药物0.06vs.3.70，静脉注射阿片类药物0.01vs.0.45，全部P值<0.001）。
结论：虽然在CD期间使用神经轴吗啡似乎是安全有效的，术后尿潴留的风险似乎由于其使用而增加。通过膀胱导管插入术治疗的明显尿潴留病例不会导致短期并发症。
目的：确定CD期间向神经轴注射吗啡是否会影响术后尿潴留率。
方法：我们对接受CD的患者进行了回顾性病例对照观察研究。我们将使用鞘内或硬膜外腔注射吗啡的患者（2020年11月至2021年10月）与无吗啡的CD患者的历史队列（2019年11月至2020年10月）进行了比较。主要结果是术后明显尿潴留的发生率，需要进行膀胱导管检查。
结果：研究组包括283名患者，对照组313例患者符合分析条件.在基线人口统计学和CD适应症方面没有发现差异。在研究组中，由于尿retention留引起的产后膀胱导尿次数较高（5％vs.1%,P值=0.003)。没有记录30天再入院的病例。此外，使用神经轴吗啡治疗的患者需要更少的术后麻醉重复剂量（口服镇痛7.4vs.10.1，静脉镇痛0.29vs.0.31，口服阿片类药物0.06vs.3.70，静脉注射阿片类药物0.01vs.0.45，全部P值<0.001）。
结论：虽然在CD期间使用神经轴吗啡似乎是安全有效的，术后尿潴留的风险似乎由于其使用而增加。通过膀胱导管插入术治疗的明显尿潴留病例不会导致短期并发症。
