[Peritoneal dialysis catheter insertion under TAP block procedure: A pilot study]

The main objective of this study was to evaluate the feasibility of a laparotomy peritoneal dialysis insertion, under locoregional anesthesia, by transversus abdominis plane block anesthesia.

This was a retrospective study of the peritoneal dialysis catheter insertion under transversus abdominis plane block anesthesia in our center between the September 1, 2011 and July 31, 2013. The transversus abdominis plane block procedure was used as an alternative to general anesthesia. Patients who underwent a peritoneal dialysis catheter insertion under transversus abdominis plane block anesthesia were included in the study. The main criterion of the study was the pain expressed by the patient during the procedure. Postoperative complications were also evaluated. The catheter function was assessed by an infusion and drainage test just after surgical procedure, 10 days after the insertion and at dialysis initiation.

Thirty-seven patients who had one catheter insertion were included in the study. Among those 37 patients, 28 (75.7%), 26 (70.3%) and 31 (83.8%) respectively did not express any pain during the procedure, two and four hours after the catheter insertion. Of the 37 patients, 5 had an early postoperative complication (hematoma: 11%, hemoperitoneum: 3%). The peritoneal dialysis catheter function was estimated to be good just after the insertion and 10 days after the surgery for 35/37 (95%) patients. Among these 36 patients, 29 (81%) had a catheter function peritoneal dialysis initiation.

The transversus abdominis plane block anesthesia should be considered as an alternative to general anesthesia for the peritoneal dialysis insertion in comorbid end stage renal disease patient.