Side effects of spinal anesthesia

[Helori]

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!

[athomas91]

i hope all turns out well.

[sherichance]

I actually had a problem like that last year. After I got out of surgery I could not void for the longest time. Come to find out that I had so much urine in my bladder when I came out of surgery that my bladder was stretched beyond belief. The doctor inserted a catheter for almost 2 weeks. I was so afraid that when it came out that I would not be able to go but I did. I told the doctor that I have never been so happy to go to the bathroom in all my life.

But that was my problem when I had spinal anesthesia.

[athomas91]

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.

pasgasser....a few days out this wouldn't still be the problem, would it??

[pasgasser]

depending upon the pt's co-existing dzs it could (diabetes could cause the urinary retention to occur for several days). If the pt had not urinated after 72 hours I would investigate other causes. Also the type of local anesthetic is not mentioned here. If tetracaine or bupivicaine was used to help provide post-op pain the urinary retention could be longer. It is likely that the pt did not get a lidocaine SAB because 1) he was going to be an in-pt and no need for the SAB to wear off quickly 2) the incedence of transient neurologic syndrome associated with lidocaine has alot of providers avoiding it. I have started using bupivicaine for c-sections for the above reasons eventhough th OB's I work with rarely take longer than 15 minutes skin to skin on the procedure.

[athomas91]

i agree - but my thought was that due to the time it was likely another cause.

so - you have cut down on your lido use for spinals, eh?? i will have to do some research on that one...thanks for the heads up.