Safety and efficacy of non-indwelling urinary catheter in patients received intravenous combined inhaled anesthesia in total knee arthroplasty.A pilot study

Objective To prospective study the safety and efficacy of non-indwelling urinary catheter in patients undergoing total knee arthroplasty(TKA)under intravenous combined inhaled anesthesia.Methods One hundred and twelve patients scheduled to unilateral primary TKA were randomized into two groups:non-indwelling urinary catheter(NIC)group and indwelling urinary catheter(IC)group.The preoperative urination of patients in both groups was normal.All patients received inhalation and intravenous anesthesia.In IC group(n=56),catheter was removed within postoperative 12 hours,then urinary retention and urinary irritation were under the monitoring.In NIC group(n=56),patients were under the monitoring for urinary retention and urinary irritation after 4 hours of surgery.If urinary retention was diagnosed,and the conservative treatment was non-effective,urinary catheter should be placed.Urinary irritation was diagnosed by symptoms and complaints of patients,if clump count100thousand/ml,urinary tract infection would be diagnosed,clump count100/ml also had diagnostic value in patients with symptoms.Results Urinary retention,urinary irritation,urinary tract infection and length of hospital stay had not significant difference between IC group and NIC group(P0.05).Four cases were diagnosed as urinary retention in NIC group and two in IC group,they were placed catheters again,all the catheters were removed successfully after 2-3 days.Ten cases in IC group and one in NIC group were diagnosed as urinary irritation,two cases in IC group and no one in NIC group were diagnosed as urinary tract infection.Conclusions The risk of urinary retention is similar for patients of both groups when received intravenous combined inhaled anesthesia in primary TKA.Indwelling urinary catheter is not routinely needed in TKA,non-indwelling urinary catheter can contribute to decreasing the risk of postoperative urinary irritation and urinary tract infection.