Bladder function in spinal anaesthesia

Area of Science:

• Anesthesiology
• Urology

Background:

• Spinal anesthesia is commonly used for surgical procedures.
• Understanding its effects on bladder function is crucial for patient care.

Purpose of the Study:

• To compare the effects of bupivacaine and tetracaine spinal anesthesia on urodynamic parameters.
• To evaluate the recovery of bladder function and motor strength after spinal anesthesia.

Main Methods:

• 21 patients received spinal anesthesia with bupivacaine or tetracaine.
• Urodynamic studies (CO2 cystometry) assessed bladder filling, capacity, and detrusor contraction.
• Motor block was quantified for hip flexion, knee extension, and toe plantar flexion.

Main Results:

• Spinal anesthesia rapidly blocked the micturition reflex, with bladder paralysis observed within 5 minutes.
• Complete recovery of detrusor strength took 7-8 hours and did not significantly differ between anesthetic agents.
• Motor strength in lower limbs recovered 40-140 minutes before detrusor strength.
• Urethral pressure decreased by 48% and normalized around the time of detrusor recovery.

Conclusions:

• Spinal anesthesia significantly impacts bladder function, causing temporary paralysis.
• Recovery of bladder control is prolonged compared to motor function recovery.
• Bupivacaine and tetracaine show similar effects on bladder function recovery time.