Timing of indwelling urinary catheter removal in male patients undergoing orthopedic surgery under general anesthesia: a prospective controlled study_West China Medical Journal

Authors：

LI Xiangyi , XU Shengxi ,  LI Haibo , YANG Sheng , GOU Yongsheng , WANG Na , LI Ling , SHI Xueyan , GONG Dezhi , CHE Zheng , FU Bolin

Department of Orthopedics, West China (Airport) Hospital Sichuan University, the First People’s Hospital of Shuangliu District, Chengdu, Sichuan 610000, P. R. China;

Corresponding author：

LI Haibo, Email: haibo1964@163.com

Keywords：

Orthopedic surgery; indwelling catheter; general anesthesia

DOI：

10.7507/1002-0179.202207169

Video：

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Objective To explore the timing of indwelling urinary catheter removal in male patients undergoing orthopedic surgery under general anesthesia by a prospective randomized controlled study. Methods Male patients who underwent orthopedic surgery under general anesthesia in the First People’s Hospital of Shuangliu District between September 2019 and January 2021 were selected prospectively. The patients were randomly assigned to group A (pull out the catheter before anesthesia) and group B (pull out the catheter within 24 hours after anesthesia) at a ratio of 1∶1 by sortition. The age, operation duration, operation site, heart rate when pulling out the catheter, first urination, urinary tract infection, patient comfort score, nursing satisfaction score and patient satisfaction related indicators of the two groups were recorded and analyzed. Results A total of 120 patients were included in the study. All patients successfully completed the trial without dropping out or quitting. There was no significant difference between the two groups in terms of age, operation duration and operation site (P>0.05). No urinary tract infection occurred in both groups. There was no significant difference in the first urination between the two groups (P>0.05). The heart rate of patients in group A when pulling out the catheter was slower than that of group B [(74.62 ± 11.38) vs. (84.52 ± 8.98) times/min], and the satisfaction of patients in group A (group A: 46 cases were satisfied, 11 cases were relatively satisfied, 3 cases were dissatisfied; group B: 17 cases were satisfied, 25 cases were relatively satisfied, 18 cases were dissatisfied), comfort score (17.82±2.73 vs. 16.68±2.13), and nursing satisfaction score (19.62±1.59 vs. 16.32±2.05) were better than those in group B (P<0.05). Conclusions For male patients who need catheterization before orthopedic surgery under general anesthesia, pulling out the catheter before waking up after anesthesia can effectively reduce the physiological stress reaction of patients, reduce discomfort, improve patient satisfaction, and reduce the workload of nurses after surgery, which is conducive to early rehabilitation exercise of patients.

Citation： LI Xiangyi, XU Shengxi, LI Haibo, YANG Sheng, GOU Yongsheng, WANG Na, LI Ling, SHI Xueyan, GONG Dezhi, CHE Zheng, FU Bolin. Timing of indwelling urinary catheter removal in male patients undergoing orthopedic surgery under general anesthesia: a prospective controlled study. West China Medical Journal, 2022, 37(10): 1493-1496. doi: 10.7507/1002-0179.202207169 Copy

1.	邸禄芹, 丁俊琴, 崔怡, 等. 拔除导尿管时间对骨科术后患者排尿情况及舒适度的影响. 中华现代护理杂志, 2017, 23(8): 1060-1064.
2.	Thakker A, Briggs N, Maeda A, et al. Reducing the rate of post-surgical urinary tract infections in orthopedic patients. BMJ Open Qual, 2018, 7(2): e000177.
3.	Hu FW, Yeh CY, Huang CC, et al. A novel intervention to reduce noninfectious and infectious complications associated with indwelling urethral catheters in hospitalized older patients: a quasi-experimental study. BMC Geriatr, 2022, 22(1): 426.
4.	Lam TB, Omar MI, Fisher E, et al. Types of indwelling urethral catheters for short-term catheterisation in hospitalised adults. Cochrane Database Syst Rev, 2014, 23(9): CD004013.
5.	周素萍. 术后留置尿管拔除时机对拔管后首次排尿困难及尿潴留的影响. 实用临床医药杂志, 2009, 5(2): 59,63.
6.	Giles M, Graham L, Ball J, et al. Implementation of a multifaceted nurse-led intervention to reduce indwelling urinary catheter use in four Australian hospitals: a pre- and postintervention study. J Clin Nurs, 2020, 29(5/6): 872-886.
7.	Offodile AC 2nd, Gu C, Boukovalas S, Coroneos CJ, et al. Enhanced recovery after surgery (ERAS) pathways in breast reconstruction: systematic review and meta-analysis of the literature. Breast Cancer Res Treat, 2019, 173(1): 65-77.
8.	荀林娟, 施雁, 宋瑞梅, 等. 快速康复外科护理对高龄腹腔镜胆囊切除术患者手术应激及术后恢复的影响. 中华护理杂志, 2018, 53(11): 1343-1346.
9.	李玉婷, 张丽芬. 加速康复外科理念在骨科围手术期的应用. 中国疗养医学, 2022, 31(9): 936-940.
10.	Jiang M, Liu S, Deng H, et al. The efficacy and safety of fast track surgery (FTS) in patients after hip fracture surgery: a meta-analysis. J Orthop Surg Res, 2021, 16(1): 162.
11.	郭晓宇, 史冬立, 张振美, 等. 全麻腰椎术后男性患者早期拔除尿管的最佳证据总结. 护理学报, 2020, 27(11): 46-52.
12.	Griesdale DE, Neufeld J, Dhillon D, et al. Risk factors for urinary retention after hip or knee replacement: a cohort study. Can J Anaesth, 2011, 58(12): 1097-1104.
13.	Hoke N, Bradway C. A clinical nurse specialist-directed initiative to reduce postoperative urinary retention in spinal surgery patients. Am J Nurs, 2016, 116(8): 47-52.
14.	张姗姗, 陈红梅, 鲍宏玮, 等. 快速康复外科理念联合舒适护理模式在老年股骨颈骨折治疗中的应用. 海军医学杂志, 2019, 40(2): 136-139.
15.	胡晓艳. 骨科择期手术患者的两种导尿时机探讨. 实用临床护理学电子杂志, 2017, 2(15): 167.
16.	Gould CV, Umscheid CA, Agarwal RK, et al. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol, 2010, 31(4): 319-326.
17.	孙浩林, 越雷, 王诗军, 等. 腰椎后路长节段手术加速康复外科实施流程专家共识. 中华骨与关节外科杂志, 2019, 12(8): 572-583.
18.	Khan SK, Kalra S, Khanna A, et al. Timing of surgery for hip fractures: a systematic review of 52 published studies involving 291,413 patients. Injury, 2009, 40(7): 692-697.
19.	赵琪珩, 李远征, 裴艳玲. 留置导尿管的拔管时机对降低尿路感染的分析. 中华医院感染学杂志, 2014, 24(13): 3255-3257.
20.	Wald HL, Ma A, Bratzler DW, et al. Indwelling urinary catheter use in the postoperative period: analysis of the national surgical infection prevention project data. Arch Surg, 2008, 143(6): 551-557.
21.	Phipps S, Lim YN, McClinton S, et al. Short term urinary catheter policies following urogenital surgery in adults. Cochrane Database Syst Rev, 2006, 19(2): CD004374.
22.	Tenke P, Mezei T, Bde I, et al. Catheter-associated urinary tract infections - ScienceDirect. Eur Urol Suppl, 2017, 16(4): 138-143.

1. 邸禄芹, 丁俊琴, 崔怡, 等. 拔除导尿管时间对骨科术后患者排尿情况及舒适度的影响. 中华现代护理杂志, 2017, 23(8): 1060-1064.
2. Thakker A, Briggs N, Maeda A, et al. Reducing the rate of post-surgical urinary tract infections in orthopedic patients. BMJ Open Qual, 2018, 7(2): e000177.
3. Hu FW, Yeh CY, Huang CC, et al. A novel intervention to reduce noninfectious and infectious complications associated with indwelling urethral catheters in hospitalized older patients: a quasi-experimental study. BMC Geriatr, 2022, 22(1): 426.
4. Lam TB, Omar MI, Fisher E, et al. Types of indwelling urethral catheters for short-term catheterisation in hospitalised adults. Cochrane Database Syst Rev, 2014, 23(9): CD004013.
5. 周素萍. 术后留置尿管拔除时机对拔管后首次排尿困难及尿潴留的影响. 实用临床医药杂志, 2009, 5(2): 59,63.
6. Giles M, Graham L, Ball J, et al. Implementation of a multifaceted nurse-led intervention to reduce indwelling urinary catheter use in four Australian hospitals: a pre- and postintervention study. J Clin Nurs, 2020, 29(5/6): 872-886.
7. Offodile AC 2nd, Gu C, Boukovalas S, Coroneos CJ, et al. Enhanced recovery after surgery (ERAS) pathways in breast reconstruction: systematic review and meta-analysis of the literature. Breast Cancer Res Treat, 2019, 173(1): 65-77.
8. 荀林娟, 施雁, 宋瑞梅, 等. 快速康复外科护理对高龄腹腔镜胆囊切除术患者手术应激及术后恢复的影响. 中华护理杂志, 2018, 53(11): 1343-1346.
9. 李玉婷, 张丽芬. 加速康复外科理念在骨科围手术期的应用. 中国疗养医学, 2022, 31(9): 936-940.
10. Jiang M, Liu S, Deng H, et al. The efficacy and safety of fast track surgery (FTS) in patients after hip fracture surgery: a meta-analysis. J Orthop Surg Res, 2021, 16(1): 162.
11. 郭晓宇, 史冬立, 张振美, 等. 全麻腰椎术后男性患者早期拔除尿管的最佳证据总结. 护理学报, 2020, 27(11): 46-52.
12. Griesdale DE, Neufeld J, Dhillon D, et al. Risk factors for urinary retention after hip or knee replacement: a cohort study. Can J Anaesth, 2011, 58(12): 1097-1104.
13. Hoke N, Bradway C. A clinical nurse specialist-directed initiative to reduce postoperative urinary retention in spinal surgery patients. Am J Nurs, 2016, 116(8): 47-52.
14. 张姗姗, 陈红梅, 鲍宏玮, 等. 快速康复外科理念联合舒适护理模式在老年股骨颈骨折治疗中的应用. 海军医学杂志, 2019, 40(2): 136-139.
15. 胡晓艳. 骨科择期手术患者的两种导尿时机探讨. 实用临床护理学电子杂志, 2017, 2(15): 167.
16. Gould CV, Umscheid CA, Agarwal RK, et al. Guideline for prevention of catheter-associated urinary tract infections 2009. Infect Control Hosp Epidemiol, 2010, 31(4): 319-326.
17. 孙浩林, 越雷, 王诗军, 等. 腰椎后路长节段手术加速康复外科实施流程专家共识. 中华骨与关节外科杂志, 2019, 12(8): 572-583.
18. Khan SK, Kalra S, Khanna A, et al. Timing of surgery for hip fractures: a systematic review of 52 published studies involving 291,413 patients. Injury, 2009, 40(7): 692-697.
19. 赵琪珩, 李远征, 裴艳玲. 留置导尿管的拔管时机对降低尿路感染的分析. 中华医院感染学杂志, 2014, 24(13): 3255-3257.
20. Wald HL, Ma A, Bratzler DW, et al. Indwelling urinary catheter use in the postoperative period: analysis of the national surgical infection prevention project data. Arch Surg, 2008, 143(6): 551-557.
21. Phipps S, Lim YN, McClinton S, et al. Short term urinary catheter policies following urogenital surgery in adults. Cochrane Database Syst Rev, 2006, 19(2): CD004374.
22. Tenke P, Mezei T, Bde I, et al. Catheter-associated urinary tract infections - ScienceDirect. Eur Urol Suppl, 2017, 16(4): 138-143.

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Timing of indwelling urinary catheter removal in male patients undergoing orthopedic surgery under general anesthesia: a prospective controlled study

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