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Peritoneal dialysis (PD) is a procedure that facilitates the exchange of solutes, waste products, electrolytes, and excess fluid between the blood in the peritoneal capillaries and a dialysis solution introduced into the peritoneal cavity.Principles of Peritoneal Dialysis (PD)Diffusion: Waste products such as urea and electrolytes move from high concentrations in the blood to low concentrations in the dialysate across the peritoneal membrane. This mechanism is driven by the concentration...
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[Peritoneal dialysis catheter insertion under TAP block procedure: A pilot study].

Emmanuelle Hecquet1, Cécile Bonamy2, Catherine Levesque2

  • 1Service de néphrologie, CHU Clémenceau, 14033 Caen cedex, France.

Nephrologie & Therapeutique
|April 30, 2015
PubMed
Summary

Transversus abdominis plane block anesthesia is a feasible alternative to general anesthesia for peritoneal dialysis catheter insertion, offering good pain control and catheter function in end-stage renal disease patients.

Keywords:
AnesthesiaAnesthésieCatheterCathéterDialyse péritonéalePeritoneal dialysis

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Area of Science:

  • Nephrology
  • Anesthesiology
  • Surgical Procedures

Background:

  • Peritoneal dialysis is a crucial treatment for end-stage renal disease (ESRD).
  • Traditional catheter insertion often requires general anesthesia.
  • Exploring alternative anesthesia methods is vital for patient safety and comfort.

Purpose of the Study:

  • To assess the feasibility of using transversus abdominis plane (TAP) block anesthesia for laparoscopic peritoneal dialysis catheter insertion.
  • To evaluate pain levels during and after the procedure under TAP block anesthesia.
  • To determine the safety and efficacy of TAP block anesthesia in ESRD patients.

Main Methods:

  • Retrospective study of 37 patients undergoing peritoneal dialysis catheter insertion with TAP block anesthesia.
  • TAP block was used as an alternative to general anesthesia.
  • Pain assessment during the procedure and postoperatively, along with complication evaluation and catheter function tests.

Main Results:

  • A significant majority of patients experienced no pain during the procedure (75.7%) and at 2 (70.3%) and 4 (83.8%) hours post-insertion.
  • Early postoperative complications were low, including hematoma (11%) and hemoperitoneum (3%).
  • Catheter function was good in 95% of patients immediately after insertion and at 10 days, with 81% achieving successful dialysis initiation.

Conclusions:

  • Transversus abdominis plane block anesthesia is a viable and safe alternative to general anesthesia for peritoneal dialysis catheter insertion.
  • This technique offers effective pain management and ensures good catheter function in comorbid ESRD patients.
  • TAP block anesthesia should be considered for patients requiring peritoneal dialysis catheter placement.