Postoperative Continuous Infusion of Local Anesthesia in Hand-Assisted Retroperitoneoscopic Living Donor Nephrectomy

Area of Science:

• Nephrology
• Anesthesiology
• Surgical Pain Management

Background:

• Effective postoperative pain management is crucial for living kidney donor comfort and acceptance.
• Standard pain treatment (SPT) using opioids has limitations due to side effects.
• Continuous infusion of local anesthesia (CILA) is a potential alternative for pain control.

Purpose of the Study:

• To evaluate if CILA can decrease opioid requirements in living kidney donors undergoing hand-assisted retroperitoneoscopic donor nephrectomy (HARP).

Main Methods:

• An observational study involving 30 living kidney donors.
• Comparison of morphine equivalents (MEQ) administered between CILA and SPT groups.
• Data collected on postoperative days 0, 1, 2, and 3.

Main Results:

• CILA group received significantly less MEQ on postoperative day 0 (P = .009).
• On day 1, CILA showed a trend towards reduced MEQ, but was not statistically significant (P = .150).
• No significant difference in MEQ between groups on days 2 and 3, or overall.

Conclusions:

• CILA appears effective for managing pain in the initial 24 hours after HARP.
• The analgesic effect of CILA diminishes by 48 hours post-surgery.
• The efficacy may be influenced by the concurrent use of potent non-opioid analgesics.