Side effects of spinal anesthesia

athomas91 · Jul 20, 2004

the liklihood of that being related to the spinal is low...it is more likely due to a pre-existing prostatic problem or a uti....

Helori · Jul 20, 2004

Thanks, that's pretty much what I figured but wanted to know for sure. It just ticked me off that they wanted to d/c him without investigating the problem and just let the home care nurse take care of the catheter.

Today is the third time they've taken out the cath and had to re-insert it because he couldn't void. He's never had a uro/prostate problem before. I just wish the hospital was doing more to find out what is causing the problem, as far as I know they haven't even sent a urine C&S.

loisane · Jul 20, 2004

HLR,

How is your grandfather's mobility since the surgery? In my days of ortho, knees took a bit of time to get back on their feet (but maybe that has improved in this century).

Seems like the older fellas just really, really need that "feet on the floor" sensation to accomplish any liquid output. Maybe he'll be better when he is steadier on his feet?

Just a thought. Good luck to you both.

loisane crna

Helori · Jul 20, 2004

That was the first thing I thought of too, that he probably couldn't pee lying in bed. But since then he has been up walking (with assistance) and they have stood him up when he's trying to void. But he is a very private man and I guess it's probably not surprising that he would have trouble peeing with 2 people watching, I know I would!!

Thanks for the good wishes!!

athomas91 · Jul 20, 2004

i understand it is frustrating...but in an objective view - (because it isn't my grandfather...) you cannot pay a thousand dollars a day for something that can be taken care of with a home nurse and catheter and office visit...of course i wouldn't want to hear that either...but i would have the doc do a urine test - and it is a huge liklihood that your grandfather has undx BPH and goes to the BR 300X during the nite because his bladder doesn't fully empty due to constriction - a small amt of swelling (due to an indwelling cath) could be all it takes to make that stricture worse...

sunnybrook83 · Jul 20, 2004

My grandfather just had knee replacement surgery under a spinal. He's doing great, except for the fact that he had not been able to urinate since the surgery. Twice he has had his catheter taken out and had to have it put back in since he could not void on his own. Now they are talking about discharging him with the catheter still in place, which isn't a big deal except that I would like to know what is causing the problem. Is there any chance that it is a result of damage from the spinal???
Hopefully somebody out there will have some information. Thanks for your help!

Is he on any new meds that he wasn't on before? Pain meds? Especially morphine? Can cause urinary retention. (Check for duramorph in the spinal.) Good luck- hope he can pee on his own soon!

sproutsfriend · Jul 20, 2004

Could it possibly be cauda equina syndrome? How's the bowel function?

My grandfather just had knee replacement surgery under a spinal. He's doing great, except for the fact that he had not been able to urinate since the surgery. Twice he has had his catheter taken out and had to have it put back in since he could not void on his own. Now they are talking about discharging him with the catheter still in place, which isn't a big deal except that I would like to know what is causing the problem. Is there any chance that it is a result of damage from the spinal???
Hopefully somebody out there will have some information. Thanks for your help!

SproutRN · Jul 20, 2004

Could it possibly be cauda equina syndrome? How's the bowel function?

Ummmm, my friend, you seem to have forgotten the other s/s associated with cauda equina like permanent sensory and motor dysfunction. Hope you didn't miss that on our test today! :rolleyes:

I'm gonna have to find a smarter friend to study with!

Sprout :nurse:

ctbsurf · Jul 21, 2004

ummmm, actually not always, my friend.

pain and defecits relayed to CES depend on the specific nerve roots affected...

so if sacral roots 3-5 are affected they may have pain in their perineum, lack of bulbocavernosus and anal sphincters function. so yes it is possible to have CES and not have pain in your legs which would be nerve roots L2-S2.

CES possible, yet not likely unless.... he recieved a saddle block which might increase his chances.

so where do you want meet to study!!

pasgasser · Jul 21, 2004

Urinary function is usually the last thing to return after SAB, this is lilkely the cause of your grandfather's issue. Nothing to worry about give it time. Because of this issue many providers including myself choose not to use SAB for out-pt procedures.

Helori · Jul 21, 2004

I was just talking to my father, my grandpa is scheduled to be d/c'd tomorrow with the catheter. He's walking on his own, doing stairs and feeling great.

Now let's see if I can remember all the questions:

Athomas91, I was worried and frustrated and at the same time trying to reassure my father & grandma that everything was fine and a cath wasn't a big deal. I didn't expect them to keep him in the hospital just because he couldn't pee, but I was hoping that they would look into why he was having the problem while he still had to be there with his knee. At the same time I didn't want to be one of those family members that the nurses warn each other about. Why is it sometimes so hard to be just a family member and not a nurse? Thanks for understanding that.

Sunnybrook83, he was on morphine for the first day or so but since then has been taking T#3's. I don't know what was in the spinal. Thanks for the good wishes.

Sproutsfriend, SproutRN & Ctbsurf, he needed an enema after surgery but I don't think he's had any problems since then. I work on a neuro floor and had thought of CES but figured it was a pretty remote possibility and it wasn't accompanied by any loss of sensory or motor function, although you three seem to know a lot more about it that I do!!!

Pasgasser, thanks for the info.

Anyway he's got a referral to see a urologist and a home care nurse will be visiting for his dressing changes so that's already set up. I figured it was nothing I just thought of all the patients I've seen who had trouble voiding after spine surgery and wondered if a spinal could cause the same problems. I guess now I just have to trust his doctors and nurses to do their jobs and just be a granddaughter!!! :) Thank you all!!!