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Betanecol in the treatment of spinal morphine-induced urinary retention

BACKGROUND AND OBJECTIVES: Morphine has been used in spinal blocks for postoperative analgesia due to its prolonged and intense analgesic potential. Even so, its side effects very often limit its use. Urinary retention is one of them. METHODS: Of forty-seven patients submitted to surgical and obstetric procedures under spinal block with 0.1 mg morphine, 26 patients developed urinary retention (55.3%). When the classic treatment (micturition stimulation and local compresses) failed, fractionated doses of oral 12.5 mg betanecol were used at every hour, totaling 50 mg in 4 hours. After that period without appropriate response or if the patient presented intense vesical discomfort before the last dose, vesical catheterization would be performed or naloxone would be administered and the method was considered ineffective for those cases. RESULTS: The conservative treatment failed in patients with urinary retention. However, betanecol in the doses standardized in our study, was effective in 14 patient (53.8%). CONCLUSIONS: Betanecol can be a good coadjuvant for treating spinal morphine-induced urinary retention.

ANALGESICS, Opioids; ANESTHETIC TECHNIQUES, Regional; COMPLICATIONS; DRUGS


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