OP030 The effect of neuraxial anesthesia on urinary catheter removal after cesarean delivery – a comparison between spinal and epidural anesthesia: a systematic review
Bibliographic record
Abstract
Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page) Application for ESRA Abstract Prizes: I apply as a Trainee/Resident/Fellow (no age limit) Background and Aims Cesarean delivery(CD) is a common procedure with potential complications. Enhanced Recovery After Surgery(ERAS) guidelines recommend immediate removal of urinary catheters after CD. However, there’s limited evidence supporting this practice. Prolonged catheterization increases the risk of urinary tract infections(UTIs) and other complications, while premature removal can lead to urinary retention. Anesthetic type, such as spinal or epidural, may influence urinary retention. This systematic review aims to compare the effect of neuraxial anesthesia on urinary catheter removal after CD, focusing on spinal and epidural anesthesia. Methods This systematic review follows Cochrane Collaboration and PRISMA guidelines. Eligible studies include randomized controlled trials(RCT), cluster-RCT, controlled non-randomized clinical trials, cluster trials, case reports, observational cohort studies (controlled/uncontrolled), cross-sectional studies, commentary, or letters to editors. A comprehensive search was conducted in PubMed/Ovid Medline, EMBASE, Scopus, and The Cochrane Library databases from July2010-July2022. Data extraction involved study characteristics, anesthetic practices, and outcomes such as catheterization duration, urinary retention, and urinary tract infection. Results Out of 10,916 papers initially identified, five studies were included in this systematic review (figure 1). Although this review showed that neuraxial anesthesia in CD leads to higher rates of urinary-retention and longer catheterization duration, no direct comparison between spinal and epidural anesthesia was found (table 1). The heterogeneity in study populations, anesthetic methods, and definitions of urinary retention precluded quantitative comparisons. Conclusions This study reveals insufficient studies comparing epidural and spinal anesthesia regarding urinary catheterization duration after CD. Further research is needed to investigate and differentiate the effects of epidural and spinal anesthesia on urinary catheterization duration in this context.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.011 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.009 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".