La utilidad del sondaje vesical prequirúrgico en las artroplastias de rodilla y cadera

Sandra Larrauri Cantero, Carolina Zorrilla Varela, María Sanz González, Melissa Cavada Fernández, Mª Rosario Menéndez Ba, Pablo Gutiérrez de Rozas Artigarraga, Guadalupe García de Luis

Resumen


Los estudios revisados muestran que uno de los efectos adversos de la anestesia raquídea, es la retención anormal de orina (RAO). Los pacientes que van a ser intervenidos de artroplastia total de cadera o rodilla suelen presentar además factores que conllevan la necesidad de sondaje vesical en el postoperatorio.

El propósito del estudio es demostrar que la realización de la técnica del sondaje vesical sin factores adversos, reduce la incidencia de infección urinaria. Los factores a estudio son: el estrés al que está sometido el personal de enfermería en la Unidad de Recuperación Postanestésica (URPA) ante una reacción vasovagal desencadenada por una RAO, la baja movilidad que presentan los pacientes tras ser intervenidos, etc.

Realizaremos un estudio analítico longitudinal retrospectivo de casos y controles. La población a estudio serán pacientes intervenidos de artroplastia total de rodilla o cadera bajo anestesia raquídea comprendidos entre 2008 y 2010 que han precisado sondaje vesical bien sea prequirúrgico o en el postoperatorio inmediato.

Si los datos avalan nuestra hipótesis se podría poner en marcha un Protocolo de Enfermería de sondaje vesical prequirúrgico a pacientes con alto riesgo de desencadenar una RAO tras ser intervenidos de artroplastia total de rodilla o cadera.

Palabras clave:
- Sondaje vesical.
- Artroplastia de cadera.
- Artroplastia de rodilla.
- Perioperatorio.
- Anestesia raquídea.

LoA systematic review of spinal anaesthetic studies shows an abnormal urinary retention (AUR) as one of the adverse effects. Patients who are going to undergo a total hip or knee arthroplasty surgery may suffer from painful distended bladder and they need to be catheterized during the postoperative period.

The aim of this study is to show that the technique procedure of urinary catheterization, without adverse factors, reduces the incidence of urinary tract infection. The factors to study are: the nurse’s stress when a vasovagal episode appears as result of ARU in the Recovery room; the reduced mobility when patients underwent surgery, etc.    

A longitudinal retrospective analytical study of cases and controls will be carried out. The population studied will be patients undergone total hip or knee arthroplasty surgery with spinal anaesthesia. The sample will include whose will need urinary catheterization either during the preoperative or postoperative period. The period of the study will be from 2008 to 2010.   

If the data supports our hypothesis a “Nursing protocol for preoperative urinary catheterization in patients with high-risk for AUR; which will have to undergo total hip or knee arthroplasty surgery” will be carry out.

Keywords:
- Urinary catheterization
- Hip arthroplasty
- Knee arthroplasty
- Preoperative
- Spinal anaesthetic.


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Referencias


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