Management of bladder volumes when using neuraxial anesthesia

The major principles of management of bladder function during outpatient neuraxial blockade include choice of short-acting local anesthetics, avoidance of adding epinephrine, and reasonable fluid administration (750 to 1000 mL) to avoid overdistention of the bladder. Data suggest that low-risk patients are at no greater risk of retention than after general anesthesia, and may be discharged home with similar instructions regarding return if unable to void. High-risk patients may require closer monitoring with a BUS, and catheter drainage if volumes exceed 600 mL.