대한대장항문학회

Purpose : Urinary retention is a frequent postoperative complication after benign anorectal<br>surgery. Factors, known to affect postoperative urinary retention, are age, sex, anesthetics,<br>operative method, operative time and perioperative fluid injection. This study was performed<br>to know whether the incidence of urinary retention might be controlled by reducing the<br>amount of perioperative fluid. Methods : Eighty patients underwent surgery for hemorrhoids<br>and chronic anal fissures were allocated into two groups, fluid restriction group (n=37) and<br>hydration group (n=43). All patients were consecutively randomized from May 1998 to<br>January 1999 and they were under 50 years old without urologic abnormality. Fluid was<br>infused at 100 ml/h from the midnight then it's rate was changed into 10 ml/h for 4 hours<br>from the beginning of the anesthesia for the restriction group, whereas 1000 ml/h only during<br>operation for the hydration group. Thereafter it was changed into the same rate with 100<br>ml/h on both groups. Results : There was no significant differences with regard to age, sex,<br>operation time, degree of pain and use of analgesics between two groups. Although there was<br>a significant difference in the total volume of the infused fluid (Restriction group: 53.4 119.5<br>ml versus Hydration group: 778.6 319.0 ml, mean SD, p＜0.001). Catheterization was done<br>in 29 patients of the restriction group (78.4%) and 37 patients of the hydration group (86.0%),<br>respectively. The frequency of catheterization was 1.3 0.7 times in the former and 1.6 0.7<br>times in the latter group. Conclusions : A strict restriction of fluid infusion appeared to be<br>unnecessary for the purpose of preventing the urinary retention during surgery of benign<br>anorectal diseases with spinal anesthesia.<br>