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KMID : 0378019940370080058
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New Medical Journal
1994 Volume.37 No. 8 p.58 ~ p.62
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Preventive Therapy for Voiding Dysfunction after Epidural Anesthesia
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Abstract
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The autonomic nervous system of bladder neck is consisted of mainly the sympathetic nerve. The major type of their recepter is alpha-1. Because urinary filling stimulate sympathetic flow, resting tone of bladder neck is increased. After epidural anesthesia, bladder filling sense is decreased and voluntary movement of pelvic floor muscle become difficult. Many other factors may cause difficult urination after operation with epidural anesthesia (i. e. emotional stress, environmental inadequacy, postoperative pain...) .
We evaluated the effect of short(prazosin) and long acting(doxazosin) sympathetic alpha-i blocking agent for improvement of self voiding after operation with epidural anesthesia. In a prospective randomized study, the effects of short and long acting alpa-1 blocking agents were analysed with blind test. According to our results, forty-one(70.7%) of 58 patients (control group) developed urinary retention. In 11 of 25 patients (44%), who were treated with prazosin, were noted urinary retention. Another 25 patinents of which treated with doxazosin showed retention only 6 patients (24%) (p4).0003) . Mean catheterization rate in patients who could not self voiding was 1.61 in control group (41 cases), 1.27 in prazosin treated group (11 cases) and 1 in doxazosin medicated group (6 cases) (p=0.0099) . This report shows the adrenergic alpha-1 receptor blocking agents were helpful for improvement of self voiding after urologic surgery with epidural anesthesia. Long acting alpha-1 blocking agent (doxazosin) was more effective than short acting one (prazosin) .
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