The effect of intermittent versus continuous bladder catheterization on labor duration and postpartum urinary retention and infection: a randomized trial

J Clin Anesth. 2008 Dec;20(8):567-72. doi: 10.1016/j.jclinane.2008.06.009.

Abstract

Study objective: To assess the effect of intermittent versus continuous bladder catheterization on labor duration and local anesthetic consumption.

Design: Randomized, controlled, prospective, single-blind trial.

Setting: University-affiliated hospital.

Patients: 209 ASA physical status I and II, primiparous parturients who received patient-controlled epidural analgesia for labor.

Interventions: Patients were randomly allocated to either the intermittent bladder catheterization group (Group IC; n = 109) or the continuous catheterization group (Group CC; n = 100).

Measurements: Duration of the second stage of labor, dose of local anesthetics given, and primary outcomes were compared by group using the t-test for independent samples. Main secondary outcomes were postpartum urinary retention and rate of postpartum urinary tract infection (UTI; asymptomatic bacteruria).

Main results: Duration of the second stage of labor was longer in Group CC than Group IC: 105 +/- 72 vs. 75 +/- 52 min (P = 0.002). This finding was associated with increased local anesthetic dose requirement in Group CC during both stages of labor (73 +/- 25 mL vs. 63 +/- 26 mL; P = 0.005). The rate of UTI was similar (30%) in both study groups.

Conclusion: Intermittent bladder catheterization was associated with shorter second-stage labor and less local anesthetic, but the same frequency of postpartum urinary retention and UTI was seen with both catheterization groups.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anesthesia, Epidural / adverse effects*
  • Anesthesia, Obstetrical / adverse effects
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / adverse effects
  • Dose-Response Relationship, Drug
  • Female
  • Hospitals, University
  • Humans
  • Labor Stage, Second
  • Labor, Obstetric*
  • Obstetric Labor Complications / etiology
  • Obstetric Labor Complications / prevention & control
  • Postpartum Period
  • Pregnancy
  • Prospective Studies
  • Single-Blind Method
  • Time Factors
  • Treatment Outcome
  • Urinary Catheterization / methods*
  • Urinary Retention / etiology
  • Urinary Retention / therapy*
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / etiology
  • Young Adult

Substances

  • Anesthetics, Local