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Overdistention of the urinary bladder during and after anaesthesia

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Summary and Conclusions

Four cases are reported of patients who developed respiratory difficulty, a rise in blood pressure, or excitement during or after “non-traumatic” surgery under light nitrous-oxide-oxygen-halothane anaesthesia while receiving balanced salt solutions, intravenously, in excess of the estimated or measured blood loss. The complications were attributable to overdistention of the urinary bladder and were instantaneously relieved following removal of the urine by catheterization.

In view of the trend to maintain light planes of general anaesthesia and to use balanced salt solutions for intravenous therapy, it is recommended to encourage emptying of the bladder prior to the onset of anaesthesia, and to gauge fluid replacement according to the expected extent of sequestration and blood loss. The use of an open indwelling urinary catheter may be desirable during prolonged surgery.

Failure to recognize overdistention of the urinary bladder may lead to erroneous therapy of the ensuing signs and symptoms.

RéSUMé

Nous racontons l’histoire de quatre malades qui ont présente des troubles respiratoires, une élévation de la tension artérielle, de l’excitation durant ou après de la chirurgie “non traumatique” sous anesthésie légère au protoxyde d’azote, oxygène et halothane en même temps qu’ils recevaient une solution salée isotonique, par voie endoveineuse, en excès des pertes sanguines estimées ou mesurées. Ces complications ont été attributès à la surdistension vésicale et ont cédé instantanément à la suite d’une cateéthérisme vésical.

Etant donné la tendance à maintenir des plans superficiels d’anesthésie générale et à administrer des solutions salées isotoniques en thérapie endoveineuse, il est à conseiller de vider la vessie avant l’induction de toute anesthésie et de calculer le remplacement des liquides d’après la perte de sang prévue. Au cours de la chirurgie de longue durée, il serait même désirable d’installer une sonde à demeure et de la laisser ouverte.

Ne pas diagnostiquer une surdistension vésicale peut faire instituer une fausse thérapie pour corriger les symptômes mentionnés ci-haut.

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Correspondence to Gertie F. Marx or Louis R. Orkin.

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Marx, G.F., Orkin, L.R. Overdistention of the urinary bladder during and after anaesthesia. Can. Anaes. Soc. J. 13, 500–504 (1966). https://doi.org/10.1007/BF03003616

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Keywords

  • Halothane
  • Urinary Bladder
  • Balance Salt Solution
  • Light Plane
  • Trimethaphan