Anticholinergics and cholinesterase inhibitors during anesthesia may need to be avoided in patients undergoing outpatient total joint arthroplasty in an ASC due to the risk of postoperative urinary retention, according to research published in the Journal of Arthroplasty.
Researchers examined data from 685 consecutive, unilateral total joint arthroplasty patients who were discharged the same day or the day after their surgery. Postoperative urinary retention was diagnosed by a perioperative internal medicine specialist. The researchers analyzed a sample of 633 procedures.
The key research details to know:
1. Postoperative urinary retention incidence was 5.5 percent, and 3.9 percent for same day discharges.
2. Outpatient surgery was not associated with an increased risk of postoperative urinary retention.
3. A history of urinary retention and male sex were associated with acute postoperative urinary retention, in addition to rocuronium glycopryrrolate, fentanyl spirals and neostigmine use.
Researchers concluded, "Despite a relatively low incidence of 5.5 percent, avoidance of anticholinergics and cholinesterase inhibitors during anesthesia should be carefully considered in outpatient TJA, particularly in stand-alone ambulatory surgery centers.