ABSTRACT
Background: Postoperative urinary retention is a commonly encountered problem after anal surgery particularly under spinal anesthesia. Bethanchol chloride, a muscarinic cholinergic receptor agonist was used to determine whether it could prevent this problem. Methods: One hundred six patients with mean age of 37+ 9 who underwent anal surgery under spinal anesthesia from January to August 2007 were included in this nonblinded randomized prospective experimental study. Forty- six patients were given bethanechol chloride 25mg/tab 1 hour post- op then another dose after 4-6 hours. Those with the urge to void but unable to do so within the hour or had hypogastric pain (VAS > 8) were immediately catheterized and the amount drain recorded. Conclusion: Although bethanechol chloride did not completely prevent the development of postoperative urinary retention, it use was associated with reduced need for the catheterization.
Subject(s)
Humans , Adult , Bethanechol , Urinary Retention , Anesthesia, SpinalABSTRACT
Objective: This study sought to validate Surgical APGAR Score in predicting major postoperative complications 30 days after surgery in our hospital setting. Methods: All patients undergoing major general surgery in Chinese General Hospital and Medical Center from March to October 2009 were enrolled. Three intraoperative variables were measured: estimated blood loss (EBL), lowest mean arterial pressure (LMAP) and lowest heart rate (LHR). Base on these three variables, Surgical APGAR Scores were obtained. Resulting data were analyzed and the relationship between the scores and the incidence of major complications evaluated. Results: Eighty patients were enrolled in this study. There was a significant association of incidence of major complications decreased monotonically. The optimum cutoff point was <= 6. At this cutoff point, sensitivity was 80%, specificity was 78.57%, positive predictive value was low at 34.8%, while negative predictive value was high at 96.5%. Conclusion: Results showed that a simple surgical score can be derived from intraoperative data alone that are readily available. It validated that this 10-point scoring system based on estimated blood loss (EBL), lowest mean arterial pressure (LAMP) and lowest heart rate (LHR) can predict group of patients at higher risk of major complications within 30 days of surgery. This system can be a significant tool for prognostification and clinical guide for early intervention of postoperative care in surgery. Key words: estimated blood loss, lowest mean arterial pressure