Duration of Urinary Catheterization Following Cesarean Deliveries Under Neuraxial Anesthesia

Официальное название

Duration of Urinary Catheterization Following Cesarean Deliveries Under Neuraxial Anesthesia: A Prospective Cohort Study

Обзор

In cesarean deliveries, urinary catheters are often used to help empty the bladder while patients have limited mobility. These catheters typically stay in during early recovery because certain pain medications can make it hard for patients to urinate. Recently, the Society of Obstetric Anesthesia and Perinatology (SOAP) recommended removing catheters within 6-12 hours after delivery to aid recovery. However, at BC Women's Hospital, a review found that catheters stayed in for an average of 19 to 19.4 hours, even when patients were mobile. Leaving catheters in too long can increase the risk of urinary tract infections (UTIs), pain, and urination issues, which can delay recovery and extend hospital stays. An internal review showed that factors like patient anxiety may affect when catheters are removed. Postpartum anxiety affects around 9.9% to 20.7% of new mothers in the first year and is an important factor in recovery after a cesarean delivery. The main goal of this study is to look at how long urinary catheters stay in patients who had a cesarean delivery under spinal or epidural anesthesia, and what the score is from a questionnaire used to measure anxiety called the State Trait Anxiety Inventory (STAI-S), to see if there is a link between them.

Подробное описание

This study aims to analyze how long foley catheters stay in the patient after their cesarean delivery under neuraxial anesthesia and what barriers there are in taking them out earlier.

Первичные конечные точки

• Correlation between duration of urinary catheterization and STAI-S score [Срок оценки: From the time of enrollment until urinary catheter removal, assessed up to 24 (+/- 8) postpartum.]

Вторичные конечные точки (4)

• Timing of delivery [Срок оценки: From urinary catheter placement until its removal, assessed up to 24 (+/- 8) hours postpartum, categorized based on delivery time (e.g., morning: 06:00-11:59, afternoon: 12:00-17:59, evening/night: 18:00-05:59)]
• Neuraxial Technique [Срок оценки: From urinary catheter placement until its removal, assessed up 24 (+/- 8) hours postpartum, categorized by neuraxial technique used during delivery]
• Opioid Dose [Срок оценки: From urinary catheter placement until its removal, assessed up to 24 (+/- 8) hours postpartum, categorized by total neuraxial opioid dose administered.]
• Nursing Perception [Срок оценки: Survey completed by the patient's postpartum nurse within 24 (+/- 8) hours after urinary catheter removal.]

Критерии участия

Критерии включения

• Patients ≥19 years of age.
• Undergoing cesarean delivery (elective or emergent) at BC Women's Hospital.
• Neuraxial anesthesia as their primary mode of anesthesia (spinal, epidural, combined spinal-epidural, dural-puncture epidural).
• In-patient status at 24 (+/- 8) hours.
• Self-reported proficiency in speaking and reading English.

Критерии исключения

• Refusal to participate.
• Inability to provide informed consent.
• Other surgery (i.e. cervical cerclage) or delivery modes (i.e. operative vaginal delivery).
• De novo general anesthetic, or patients who had a conversion from neuraxial to a general anesthetic.
• Communication from patient's nurse indicating that it is not appropriate to approach due to distressing birth experience and/or outcome.

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Канада · 1 центр

• BC Women's Hospital — Vancouver

Публикации

• Figueiredo B, Conde A. Anxiety and depression in women and men from early pregnancy to 3-months postpartum. Arch Womens Ment Health. 2011 Jun;14(3):247-55. doi: 10.1007/s00737-011-0217-3. Epub 2011 Apr 9. PMID 21479759
• Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11(0 11):S467-72. doi: 10.1002/acr.20561. No abstract available. PMID 22588767
• Goodman JH, Watson GR, Stubbs B. Anxiety disorders in postpartum women: A systematic review and meta-analysis. J Affect Disord. 2016 Oct;203:292-331. doi: 10.1016/j.jad.2016.05.033. Epub 2016 Jun 1. PMID 27317922
• Sutherland E, Yang T, Chau A. Duration of Urinary Catheterization After Cesarean Deliveries: A Retrospective Cohort Study..Poster session presented at: 2023 Summer Student Poster Day; 2023 Jul 27; Chieng Family Atrium, BC Children's Research Institute
• Bollag L, Lim G, Sultan P, Habib AS, Landau R, Zakowski M, Tiouririne M, Bhambhani S, Carvalho B. Society for Obstetric Anesthesia and Perinatology: Consensus Statement and Recommendations for Enhanced Recovery After Cesarean. Anesth Analg. 2021 May 1;132(5):1362-1377. doi: 10.1213/ANE.0000000000005257. PMID 33177330
• Basbug A, Yuksel A, Ellibes Kaya A. Early versus delayed removal of indwelling catheters in patients after elective cesarean section: a prospective randomized trial. J Matern Fetal Neonatal Med. 2020 Jan;33(1):68-72. doi: 10.1080/14767058.2018.1487394. Epub 2018 Jul 18. PMID 29886771

Идентификаторы

NCT: NCT06881849 · H24-03410

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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