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J Surg Res ; 233: 100-103, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30502234

RESUMEN

BACKGROUND: In some institutions, urinary catheters (UCs) have been placed in all patients receiving opioid patient-controlled analgesia (PCA) because of the increased incidence of urinary retention. Our institutional data demonstrated no UC replacements in 48 children who had PCA for perforated appendicitis who had their catheters removed before discontinuation of the PCA. As part of a quality improvement initiative, we discontinued the practice of requiring UC with PCA for perforated appendicitis. MATERIALS AND METHODS: A prospective list of patients with perforated appendicitis was maintained. Data were gathered regarding 60 consecutive patients. UC placement was allowed for specific indications including urinary retention and surgeon discretion. RESULTS: Sixteen patients (27%) received a UC with 14 of these being placed in the operating room (OR). Two UCs were placed outside the OR for urinary retention. Patients who underwent UC placement in the OR weighed significantly more than those who did not (33 versus 42 kg, P = 0.05). No patients required replacement of the catheter once removed. There were no postoperative urinary tract infections. Median PCA duration was 68 h (50, 98) for patients with UC placed in the OR compared with 60 h (47, 78) (P = 0.42). Median postoperative length of stay for patients with UC placed in the OR was 95 h (76, 140) compared with 90 h (70, 113) (P = 0.09). CONCLUSIONS: UC can be withheld from patients with perforated appendicitis who are placed on PCA with a very low placement rate. UC placement at time of operation did not lengthen time receiving PCA or length of stay.


Asunto(s)
Analgesia Controlada por el Paciente/efectos adversos , Apendicectomía/efectos adversos , Apendicitis/cirugía , Dolor Postoperatorio/tratamiento farmacológico , Retención Urinaria/prevención & control , Adolescente , Analgésicos Opioides/administración & dosificación , Catéteres de Permanencia/efectos adversos , Niño , Preescolar , Femenino , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Dolor Postoperatorio/etiología , Guías de Práctica Clínica como Asunto , Estudios Prospectivos , Factores de Tiempo , Resultado del Tratamiento , Cateterismo Urinario/efectos adversos , Cateterismo Urinario/instrumentación , Cateterismo Urinario/normas , Catéteres Urinarios/efectos adversos , Retención Urinaria/etiología
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