Postoperative Urinary Retention in Patients After Noncardiac Surgery and Reversal of Neuromuscular Block

Inclusion Criteria

• Informed Consent as documented by signature;
• Adults having noncardiac surgery with expected surgery duration ≥ 2 hours;
• General anesthesia requiring endotracheal intubation and neuromuscular block with rocuronium or vecuronium;
• Planned administration of sugammadex or neostigmine for reversal of the neuromuscular block at the end of surgery;
• American Society of Anesthesiologists (ASA) physical status 1-3;
• Age ≥ 65 years.

Exclusion Criteria

• Contraindications to the class of drugs under study;
• Preoperative urinary catheter;
• Planned intraoperative insertion of a urinary catheter;
• Neurosurgery (except spine surgery), intraabdominal or retroperitoneal surgeries including but not limited to any kind of laparoscopies, or surgeries in kidneys, ureters or urine bladder.
• Planned postoperative admission to the ICU;
• Severe preoperative hepatic impairment (≥3 times increase in aspartate aminotransferase or alanine aminotransferase as per reference range) or renal impairment (estimated GFR < 30 ml/min or end-stage renal disease requiring scheduled dialysis.);
• History of bladder cancer;
• Presence of a sacral nerve stimulator;
• Current use of anticholinergic medications such as antihistamines, phenothiazines, antidepressants or antipsychotics;
• Urinary tract infections or other urogenital comorbidity (incontinence, cysto-ureteric reflux, known bladder retention) or conditions which promote urinary retention;
• Known or suspected neurological conditions such as Alzheimer's disease, stroke, poliomyelitis, cerebral palsy, multiple sclerosis, spinal lesions, or Parkinson's disease.