Combined Spinal Epidural Urinary Retention

Stopped early · Not applicable

Conditions studied: Anesthesia, Pain, Urinary Retention

In brief

The investigators hypothesize that many parturients can, in fact, spontaneously micturate with low dose combined spinal epidural analgesic doses given for labor and that Foley catheterization is unnecessary in the majority of these parturients. At Prentice Women's Hospital, almost 9000 women annually receive neuraxial labor analgesia and 98% of those receive Foley catheters. By potentially reducing the necessity for Foley catheters, the investigators should be able to ultimately reduce the rate of bacteriuria, urinary tract infections and urethritis leading to unnecessary treatment with antibiotics, as well as reduce costs of placing unnecessary Foley catheter.The hypothesis is parturients receiving low dose combined spinal epidural analgesia for analgesia after induction of labor who are randomized to a spontaneous micturition protocol will require fewer Foley catheter placements and demonstrate a lower incidence of positive urine culture postpartum than those who undergo standard Foley catheter placement.

Key facts

Study ID

NCT01597791

Run by

Northwestern University

People needed

56

Starts

2012-03-22

Expected to finish

2016-12-01

Last updated by the study team

2018-10-05

Who can join

Age: 18 and older. Sex: female. Healthy volunteers: not accepted.

You may qualify if…

• Nulliparous
• Term (≥37 week gestation)
• Healthy
• ASA class 1-2
• Who are being induced for labor who request labor analgesia and who successfully receive standard combined spinal epidural analgesia (verbal rating score for pain ≤ 1 after 10 min)

You may not qualify if…

• Women with ASA 3 or greater
• BMI ≥40 kg/m2
• Prior history of urge or stress incontinence or urinary retention before pregnancy
• Women with a history of nephrolithiasis
• Chronic urinary tract infections
• Women whose post-void residual volume as assessed by ultrasonography is found to be >100ml before epidural placement will be excluded.
• Women with an absolute or relative contraindication to the usual combined spinal epidural technique
• Failed analgesia will be excluded
• Women for whom the anesthesiologist selects an analgesic technique other than combined spinal epidural technique or fail to obtain CSF for CSE will be excluded
• Women with fetal heart rate decelerations before request for analgesia will be excluded due to increased risk of cesarean delivery.
• Women who experience inadequate labor analgesia due to nonfunctioning epidural catheter necessitating epidural replacement will be included but noted as a protocol violation.

Where it is running

• Northwestern University — Chicago, Illinois, United States

Full record on ClinicalTrials.gov

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