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Postoperative Continuous Infusion of Local Anesthesia in Hand-Assisted Retroperitoneoscopic Living Donor Nephrectomy.
Wahba, R; Kleinert, R; Hellmich, M; Kurschat, C; Heiermann, N; Dieplinger, G; Löser, J; Stippel, D L.
Afiliação
  • Wahba R; Department of General, Visceral and Cancer Surgery, Division of Transplantation Surgery, Transplant Center Cologne, University of Cologne, Germany. Electronic address: roger.wahba@uk-koeln.de.
  • Kleinert R; Department of General, Visceral and Cancer Surgery, Division of Transplantation Surgery, Transplant Center Cologne, University of Cologne, Germany.
  • Hellmich M; Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Germany.
  • Kurschat C; Department of Medicine, Renal Division, Transplant Center Cologne, University of Cologne, Germany.
  • Heiermann N; Department of General, Visceral and Cancer Surgery, Division of Transplantation Surgery, Transplant Center Cologne, University of Cologne, Germany.
  • Dieplinger G; Department of General, Visceral and Cancer Surgery, Division of Transplantation Surgery, Transplant Center Cologne, University of Cologne, Germany.
  • Löser J; Department of Anesthesiology and Operative Intensive Care Medicine, University of Cologne, Germany.
  • Stippel DL; Department of General, Visceral and Cancer Surgery, Division of Transplantation Surgery, Transplant Center Cologne, University of Cologne, Germany.
Transplant Proc ; 48(6): 1940-3, 2016.
Article em En | MEDLINE | ID: mdl-27569926
INTRODUCTION: Postoperative pain management in living kidney donor nephrectomy plays a key role in donor comfort and is important for the further acceptance of living kidney donation in times of organ shortage. Standard pain treatment (SPT) based on opioids is limited due to related side effects. Continuous infusion of local anesthesia (CILA) into the operative field is a promising alternative. The aim of this study was to evaluate whether CILA could reduce the dose of opioids in living kidney donors operated with hand-assisted retroperitoneoscopic donor nephrectomy (HARP). METHODS: An observational study on 30 living donors was performed. The primary outcome was the difference of morphine equivalents (MEQ) administered between CILA and SPT. RESULTS: On day 0 and 1, living donors with CILA received significant less MEQ compared to the SPT group, although on day 1 this effect was not statistically significant (day 0: 6.3 mg, interquartile range [IR] 4.2-11.2 vs 16.8 mg, IR 10.5-22.1, P = .009; day 1: 5.25 mg, IR 2.1-13.3 vs 13.3 mg, IR 6.7-23.8, P = .150). On days 2 and 3 there was no difference (day 2: 13.3 mg, IR 0.0-20.0 vs 13.3 mg, IR 6.7-13.3, P = .708; day 3: 13.3 mg, IR 0.0-26.7 vs 13.3 mg, IR 6.7-20, P = .825). Overall (days 0 to3) MEQ was also less for CILA without reaching statistical significance (39.6 mg, IR 10.9-70.5 vs 59.6 mg, IR 42.4-72.9, P = .187). CONCLUSIONS: CILA seems to be an effective instrument for donor pain management in the first 24 hours after HARP. Its effect abates by 48 hours after surgery, especially if highly potent nonopioids are given.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Pós-Operatória / Transplante de Rim / Doadores Vivos / Coleta de Tecidos e Órgãos / Manejo da Dor / Anestésicos Locais Tipo de estudo: Observational_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Transplant Proc Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Dor Pós-Operatória / Transplante de Rim / Doadores Vivos / Coleta de Tecidos e Órgãos / Manejo da Dor / Anestésicos Locais Tipo de estudo: Observational_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Transplant Proc Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos