Minerva anestesiologica
-
Postoperative urinary retention (POUR) occurs after lower joint arthroplasty with an incidence between 0% and 75%. This vast range reflects the differences in diagnosis and management of POUR. At present, clinical practice includes either preoperative insertion of an indwelling catheter to be removed after 24-48 postoperative hours or postoperative intermittent in-and-out catheterization performed either at scheduled times (every 6-8 hours) or as necessary. ⋯ The purpose of the present article is to review the published data on the effects of analgesia techniques on the development of POUR after hip and knee arthroplasty. General and regional anesthesia are implicated in the etiology of POUR; however, type and duration do not correlate with its incidence. Of the different postoperative analgesic techniques currently used, continuous peripheral nerve block has the least impact on POUR.
-
Postoperative pulmonary complications (PPC) account for a substantial portion of the risks related to surgery and anesthesia and are a source of postoperative morbidity, mortality and longer hospital stays. The current basis for our understanding of the nature of PPC is weak; only a small number of high-quality studies are available, a uniform definition has not emerged, and studies have focused on specific patients and kinds of surgeries. ⋯ Age, general co-morbidity, pre-existing respiratory and cardiac diseases, the use of general anesthesia and the overall surgical insult. are the most significant factors associated with complications. Election of anesthetic technique, postoperative analgesia and physical therapy seem to be the preventive measures that are best supported by evidence.