Anesthesia and urine output....

Nurses General Nursing

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Specializes in ICU/Critical Care.

I had a couple patients come back from OR and both had a difficult time urinating. Is it something to do with the anesthesia they are given in OR? Both patients initially had a decreased urine output but over a couple of hours it picked up and they were able to put out more. Labs were WNL for both patients.

Specializes in NICU, Post-partum.

Are you talking about from the foley or they had difficulty bearing down to urinate when you tried to ambulate them?

The paralytic effects of the anesthesia is going to make it difficult to urinate the first time or so, but if you see decreased urine output from the foley, that is a sign that it's not being produced...which is not normal given the amount of IV fluids that are given during surgery.

Specializes in ICU/Critical Care.
Are you talking about from the foley or they had difficulty bearing down to urinate when you tried to ambulate them?

The paralytic effects of the anesthesia is going to make it difficult to urinate the first time or so, but if you see decreased urine output from the foley, that is a sign that it's not being produced...which is not normal given the amount of IV fluids that are given during surgery.

When I read the OR reports, the patients weren't give a lot of fluid in OR. Both patients were voiding. They urinated about 50cc when they came back from OR. They both stated they were having trouble bearing down. Over the course of my shift, they both had an easier time urinating.

I noticed that too when I worked on surgery. Most patients came back with a FC, but those who didn't had a hard time urinating at first.

Specializes in CCU & CTICU.

did they have a foley in the or? might be a problem there.

but it sounds more like anticholinergic effects.

anticholinergics/antispasmodics are also used in certain surgical and emergency procedures. in surgery, some are given by injection before anesthesia to help relax you and to decrease secretions, such as saliva. during anesthesia and surgery, atropine, glycopyrrolate, hyoscyamine, and scopolamine are used to help keep the heartbeat normal. scopolamine is also used to prevent nausea and vomiting after anesthesia and surgery.

less common side effect:

-difficult urination

http://www.mayoclinic.com/health/drug-information/dr602315

Specializes in ICU/Critical Care.
Did they have a foley in the OR? Might be a problem there.

But it sounds more like Anticholinergic effects.

No they didn't have foley caths in OR. One patient was 90 years old so she is more sensitive.

Specializes in CRNA.
I had a couple patients come back from OR and both had a difficult time urinating. Is it something to do with the anesthesia they are given in OR? Both patients initially had a decreased urine output but over a couple of hours it picked up and they were able to put out more. Labs were WNL for both patients.

There are really a ton of variables that can cause urinary retention and/or decreased UOP in the immediate postoperative period. Fluid shifts, increased circulating ADH from the posterior pituitary, residual effects of inhalational agents used, opiates, anticholingerics, pain....The list of possible causes could go on and on. Adults with a UOP of 0.5ml/kg/hr is okay. Most of the time the problem resolves itself.

Specializes in ICU/Critical Care.

You're right, it could have been from the anticholinergics. One patient's surgery was facial the other involved the patient's neck.

Yeah, I had the same thing happen to me a few weeks back. I can't remember any of the specifics, but it took the pt. several hours before their (foley) output was "normal".

Specializes in ICU/Critical Care.

Yeah, the one patient who had the facial surgery, was peeing like nothing ever happened by the end of the night.

Specializes in Oncology, Triage, Tele, Med-Surg.

If no foley to present to determine whether the kidneys are putting out urine, we use a bladder scanner to see if the patient is retaining urine.

I agree with the others on the many variables --- depends on the situation.

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