Hyperamylasemia Post Living Donor Nephrectomy Does Not Relate to Pain

Area of Science:

• Nephrology
• Surgical Oncology
• Anesthesiology

Background:

• Post-operative pain following laparoscopic donor nephrectomy is not fully understood.
• The left kidney's proximity to the pancreas raises questions about potential pancreatic inflammation and its impact on pain.
• Hyperamylasemia, an indicator of pancreatic inflammation, is a potential concern.

Purpose of the Study:

• To investigate the relationship between pancreatic inflammation (indicated by amylase levels) and post-operative pain after laparoscopic donor nephrectomy.
• To identify factors influencing pain scores in kidney donors undergoing laparoscopic nephrectomy.

Main Methods:

• Analysis of 16 consecutive live kidney donors over a three-month period.
• Measurement of serum amylase levels on postoperative days 1 and 2.
• Recording of 24-hour analgesia consumption and visual analogue scale (VAS) pain scores at rest.

Main Results:

• Three out of 16 donors exhibited hyperamylasemia; however, no correlation was found between amylase levels and pain scores.
• Multiple regression analysis indicated that levobupivacaine dose, propofol dose, transversus abdominis plane block, and day 1 amylase did not significantly predict pain.
• Body mass index showed a significant correlation with increased pain scores (p = 0.041).
• Increased CO2 insufflation pressure and the use of local anesthetic infusion catheters predicted decreased deep pain scores (p = 0.036 and p = 0.037).

Conclusions:

• Amylase levels did not correlate with pain scores in laparoscopic kidney donors.
• Pancreatitis is a rare complication of nephrectomy, with no overt cases observed in this donor nephrectomy cohort.
• Factors such as body mass index, CO2 insufflation, and local anesthetic infusion influence post-operative pain.