PATIENT-CONTROLLED ANALGESIA AND POSTOPERATIVE URINARY RETENTION AFTER OPEN APPENDECTOMY

We retrospectively studied 279 patients who had undergone uncomplicate d open appendectomy for acute appendicitis to determine risk factors f or postoperative urinary retention. The gender of the patients, the op erating time and the amount of fluid given perioperatively had no infl uence on the occurrence of retention. The amount of analgesic agent ad ministered postoperatively and the age of the patient were significant ly associated with urinary retention (p=0.01 and p<0.0001, respectivel y, after adjustment for potential confounding factors). The use of mep eridine hydrochloride as compared with morphine and of patient-control led analgesia as compared with intramuscular delivery were initially f ound to be significantly related to retention (p=0.014 and p<0.0001, r espectively). After the effects of the age of the patient, the drug ty pe and the amount of fluid and analgesic agent administered were contr olled for, patient-controlled analgesia remained significantly associa ted with retention (p<0.0001), whereas the type of drug given was no l onger significant after controlling for potential confounding factors. Because we found that urinary retention was 13 times more likely to o ccur in the patients who had patient-controlled analgesia, we recommen d that the use of this form of analgesia delivery be avoided after ope n appendectomy.