The Effects of Drugs and Anaesthetic Agents on the Urinary Bladder and Sphincters

Abstract

The influence of sedative, anaesthetic and neuromuscular blocking drugs on diagnostic urethral pressure profiles and cystometrograms has been investigated. These agents have marked effects on the results obtained; in particular, the urethral pressure profile was raised by opiates and lowered by anaesthetic induction agents. Bladder capacity as measured by the cystometrogram was greatly increased by halothane. These findings indicate that urodynamic studies should be performed only on conscious unsedated patients.

Postoperative urinary retention after general and spinal anesthesia in orthopedic surgical patients

“…In vitro work, clinical doses of halothane and thiopentone decrease bladder response to stimulation [11]. Volatile anesthetics and Sedative-hypnotics inhibit the pontine micturition center and voluntary cortical control of the bladder, suppressing detrusor contraction and the micturition reflex [12].…”

Effects of thoracic epidural analgesia on lower urinary tract function in women

“…Opioids applied intravenously inhibit detrusor function and stimulate urethral sphincter tonus resulting in a hypocontractile bladder and urinary retention. 20 The site of action of epidurally administrated fentanyl remains controversial and probably depends on the mode of administration (bolus vs. infusion). Continuous epidural infusion of lipophilic opioids such as fentanyl leads to equal spinal and supraspinal analgesia because of drug redistribution to the brain.…”

Nocturia: a blinded, randomized, parallel placebo-controlled self-study of the effect of 5 different sedatives and analgesics

“…In vitro, there was no effect on isolated detrusor strips when contractions were induced with and without diazepam, although an inhibitory effect was observed in the bladders of rats. 15 In adults or children there was no effect on bladder parameters when diazepam was administered intramuscularly, 16 or when the less lipophilic midazolam was administered as a nasal spray. 17 In comparison to these negative reports, there is extensive animal literature on spinal and supraspinal effects of BZDs, mostly mediated through GABA A receptors.…”