Evaluating a unique enhanced recovery protocol in laparoscopic donor nephrectomy: A single center experience

Area of Science:

• Nephrology
• Surgical Oncology
• Anesthesiology

Background:

• Enhanced Recovery After Surgery (ERAS) protocols are established for abdominal surgery.
• The impact of ERAS on laparoscopic donor nephrectomy (LDN) outcomes requires further investigation.

Purpose of the Study:

• To evaluate the effect of a unique LDN ERAS protocol on opioid consumption and recovery.
• To compare outcomes before and after ERAS implementation in LDN.

Main Methods:

• Retrospective cohort study of 244 LDN patients.
• Comparison of ERAS (198 patients) versus pre-ERAS (46 patients) perioperative care.
• Primary outcome: average daily oral morphine equivalent (OME) consumption; Secondary outcomes: PONV, length of stay, pain scores.

Main Results:

• ERAS donors showed significantly lower average daily OME consumption (21.5 vs. 37.6; p < .0001).
• ERAS group had reduced incidence of postoperative nausea and vomiting (PONV) (44.4% vs. 60.9%; p = .008).
• No significant difference in OME consumption between ERAS subgroups receiving or not receiving preoperative morphine.

Conclusions:

• A comprehensive ERAS protocol, including lidocaine, ketamine, and optimized perioperative management, reduces opioid consumption in LDN.
• ERAS protocols can improve recovery and reduce adverse events like PONV in LDN patients.