Abstract：
BACKGROUND: Labor analgesic interventions, particularly the use of opioids and epidural anaesthesia, have raised concerns regarding their potential impact on postpartum urinary retention (PUR), necessitating a comprehensive investigation into their association with this clinical outcome.
METHODS: This retrospective case-control study analysed clinical data from postpartum patients at our hospital from January 2023 to December 2023. Anaesthetic methods, including opioid and non-opioid drug usage, epidural analgesia and non-use of analgesia, were assessed. Logistic regression analysis was also performed to determine important associations with apparent PUR.
RESULTS: This study included clinical data from 54 postpartum patients with PUR and 54 without urinary retention. A higher percentage of women with apparent PUR received opioids during labour compared with those without PUR (p = 0.033). Conversely, a lower percentage of women with apparent PUR received non-opioid analgesics compared with those without PUR (p = 0.026). In addition, a higher percentage of women with apparent PUR received epidural analgesia compared with those without PUR (p = 0.041). Logistic regression analysis demonstrated that opioid consumption during labour was significantly associated with apparent PUR (odds ratio (OR) = 2.469, p = 0.022). By contrast, non-opioid consumption during labour was inversely associated with apparent PUR (OR = 0.297, 95% CI = 0.123-0.681, p = 0.005). In addition, the use of epidural analgesia during labour showed a remarkable association with apparent PUR (OR = 2.857, 95% CI = 1.289-6.552, p = 0.011).
CONCLUSIONS: Opioid use during labour and the use of epidural analgesia were identified as important risk factors for apparent PUR. These findings emphasise the need for a thoughtful and balanced approach to analgesic management during labour to minimise the risk of PUR in obstetric patients.
METHODS: This retrospective case-control study analysed clinical data from postpartum patients at our hospital from January 2023 to December 2023. Anaesthetic methods, including opioid and non-opioid drug usage, epidural analgesia and non-use of analgesia, were assessed. Logistic regression analysis was also performed to determine important associations with apparent PUR.
RESULTS: This study included clinical data from 54 postpartum patients with PUR and 54 without urinary retention. A higher percentage of women with apparent PUR received opioids during labour compared with those without PUR (p = 0.033). Conversely, a lower percentage of women with apparent PUR received non-opioid analgesics compared with those without PUR (p = 0.026). In addition, a higher percentage of women with apparent PUR received epidural analgesia compared with those without PUR (p = 0.041). Logistic regression analysis demonstrated that opioid consumption during labour was significantly associated with apparent PUR (odds ratio (OR) = 2.469, p = 0.022). By contrast, non-opioid consumption during labour was inversely associated with apparent PUR (OR = 0.297, 95% CI = 0.123-0.681, p = 0.005). In addition, the use of epidural analgesia during labour showed a remarkable association with apparent PUR (OR = 2.857, 95% CI = 1.289-6.552, p = 0.011).
CONCLUSIONS: Opioid use during labour and the use of epidural analgesia were identified as important risk factors for apparent PUR. These findings emphasise the need for a thoughtful and balanced approach to analgesic management during labour to minimise the risk of PUR in obstetric patients.
摘要：
背景：分娩镇痛干预，特别是使用阿片类药物和硬膜外麻醉，引起了人们对其对产后尿潴留（PUR）的潜在影响的担忧，需要对其与该临床结果的关联进行全面调查。
方法：本回顾性病例对照研究分析了2023年1月至2023年12月我院产后患者的临床资料。麻醉方法,包括阿片类药物和非阿片类药物的使用，硬膜外镇痛和不使用镇痛，被评估。还进行了Logistic回归分析以确定与表观PUR的重要关联。
结果：本研究包括54例有PUR的产后患者和54例无尿潴留的产后患者的临床数据。与没有PUR的妇女相比，有明显PUR的妇女在分娩期间接受阿片类药物的比例更高（p=0.033）。相反，有明显PUR的女性接受非阿片类镇痛药的比例低于无PUR的女性(p=0.026).此外,有明显PUR的女性接受硬膜外镇痛的比例高于无PUR的女性(p=0.041).Logistic回归分析表明，分娩期间阿片类药物的消耗与表观PUR显着相关（比值比（OR）=2.469，p=0.022）。相比之下,分娩期间的非阿片类药物消耗与表观PUR呈负相关(OR=0.297,95%CI=0.123-0.681,p=0.005).此外,分娩期间使用硬膜外镇痛与表观PUR显著相关(OR=2.857,95%CI=1.289-6.552,p=0.011).
结论：分娩期间阿片类药物的使用和硬膜外镇痛的使用被认为是明显PUR的重要危险因素。这些发现强调了在分娩期间需要一种周到且平衡的镇痛管理方法，以最大程度地降低产科患者PUR的风险。
方法：本回顾性病例对照研究分析了2023年1月至2023年12月我院产后患者的临床资料。麻醉方法,包括阿片类药物和非阿片类药物的使用，硬膜外镇痛和不使用镇痛，被评估。还进行了Logistic回归分析以确定与表观PUR的重要关联。
结果：本研究包括54例有PUR的产后患者和54例无尿潴留的产后患者的临床数据。与没有PUR的妇女相比，有明显PUR的妇女在分娩期间接受阿片类药物的比例更高（p=0.033）。相反，有明显PUR的女性接受非阿片类镇痛药的比例低于无PUR的女性(p=0.026).此外,有明显PUR的女性接受硬膜外镇痛的比例高于无PUR的女性(p=0.041).Logistic回归分析表明，分娩期间阿片类药物的消耗与表观PUR显着相关（比值比（OR）=2.469，p=0.022）。相比之下,分娩期间的非阿片类药物消耗与表观PUR呈负相关(OR=0.297,95%CI=0.123-0.681,p=0.005).此外,分娩期间使用硬膜外镇痛与表观PUR显著相关(OR=2.857,95%CI=1.289-6.552,p=0.011).
结论：分娩期间阿片类药物的使用和硬膜外镇痛的使用被认为是明显PUR的重要危险因素。这些发现强调了在分娩期间需要一种周到且平衡的镇痛管理方法，以最大程度地降低产科患者PUR的风险。
