EAJAIC
Eurasian Journal of Anesthesiology and Intensive Care

The Eurasian Journal of Anesthesiology and Intensive Care (EAJAIC) is an independent-unbiased, peer-reviewed, "double-blind", and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, differential diagnoses, editorial opinions, letters to the editor, and educational papers in anesthesiology, algology, and intensive care medicine.

ISSN: Active
eISSN: 3023-6738
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Epidural versus intravenous analgesia for pain control in kidney donors, a retrospective cohort study. Is there a kinship relationship?
Abstract
Aims: Best care must be provided for live kidney donors, including postoperative pain control. Treatment options include iv intermittent analgesics, iv or epidural patient-controlled analgesia (PCA). In this study we aimed to compare these modalities with respect to their analgesic efficacy.
Methods: A retrospective analysis of fifty-eight live donor nephrectomy patients operated in a 7-year-period in a university hospital performed. Investigational Review Board approval has been obtained. Data of the patients’ postoperative analgesia methods, degree of kinship with the recipient, postoperative pain scores, and rescue analgesic and antiemetic use were obtained. Correlation of postoperative pain scores with the analgesia technique was investigated, as well as with the degree of kinship of the donor and recipient.
Results: Patient-controlled analgesia provided better postoperative pain control, with the epidural PCA being the best. Moderate to severe pain at 6th postoperative hour in the iv intermittent, iv PCA, and epidural PCA groups was 76, 37, and 14%, respectively. Rescue analgesic use on the day of operation was 32% and 5% in the iv intermittent and iv PCA groups respectively, with no rescue analgesic use in the epidural PCA group. Postoperative antiemetic consumption was also less with the epidural PCA (P=0.024 and P=0.027 for postoperative days 1 and 2, respectively). No correlation was detected between the pain and the degree of kinship.
Conclusion: Epidural patient-controlled analgesia provides better postoperative pain control after live donor nephrectomy, compared with intravenous intermittent or patient-controlled analgesia. Postoperative pain scores were not related to the degree of kinship.

Keywords : Analgesia, kinship, postoperative pain, renal transplantation

Download Article


1. Ingelfinger JR. Risks and benefits to the living donor. N Engl J Med.2005;353(5):447-449.
2. Ratner LE, Montgomery RA, Kavoussi LR. Laparoscopic live donornephrectomy: the four year Johns Hopkins University experience.Nephrol Dial Transplant. 1999;14(9):2090-2093.
3. Brook NR, Nicholson ML. An audit over 2 years’ practice of open andlaparoscopic live-donor nephrectomy at renal transplant centres in theUK and Ireland. BJU Int. 2004;93(7):1027-1031.
4. Aboutaleb E, Herbert P, Crane J, Hakim N. Mini-incision donornephrectomy techniques: a systematic review. Exp Clin Transplant. 2010;8(3):189-195.
5. Ratner LE, Ciseck LJ, Moore RG, Cigarroa FG, Kaufman HS, Kavoussi LR.Laparoscopic live donor nephrectomy. Transplant. 1995;60(9):1047-1049.
6. Nanidis TG, Antcliffe D, Kokkinos C. Laparoscopic versus open livedonor nephrectomy in renal transplantation: a meta-analysis. AnnSurg. 2008;247(1):58-70.
7. Conacher ID, Soomro NA, Rix D. Anesthesia for laparoscopicurological surgery. Br J Anaesth. 2004;93(6):859-864.
8. Alexander JI. Pain after laparoscopy. Br J Anaesth. 1997;79(3);369-378.
9. Steinhauser MM, Dawson PB, Barshick RM, Janecek JL. Painexperienced by laparoscopic donor nephrectomy patients in anacademic medical setting. Prog Transplant. 2003;13(2):117-122.
10. Ekstein P, Szold A, Sagie B, Werbin N, Klausner JM, Weinbroum AA.Laparoscopic surgery may be associated with severe pain and highanalgesia requirements in the immediate postoperative period. AnnSurg. 2006;243(1):41-46.
11. Singh R, Sen I, Wig J, Minz M, Sharma A, Bala I. An acetazolamidebased multimodal analgesic approach versus conventional painmanagement in patients undergoing laparoscopic living donornephrectomy. Indian J Anaesth. 2009;53(4):434-442.
12. Sidebotham D, Dijkhuizen MR, Schug SA. The safety and utilization ofpatient-controlled analgesia. J Pain Symptom Manage. 1997;14(4):202-209.
13. Etches RC. Respiratory depression associated with patient controlledanalgesia: a review of eight cases. Can J Anaesth. 1994;41(2):125-132.
14. Thiyagarajan UM, Bagul A, Nicholson ML. Pain management inlaparoscopic donor nephrectomy: a review. Pain Res Treat. 2012;2012:201852.
15. Nicholson ML, Kaushik M, Lewis GRR, et al. Randomized clinicaltrial of laparoscopic versus open donor nephrectomy. J Br Surg.2010;97(1):21-28.
16. Shokeir AA. Open versus laparoscopic live donor nephrectomy: afocus on the safety of donors and the need for a donor registry. J Urol.2007;178(5):1860-1866.
17. Biglarnia AR, Tufveson G, Lorant T, Lennmyr F, Wadström J.Efficacy and safety of continuous local infusion of ropivacaine afterretroperitoneoscopic live donor nephrectomy. Am J Transplant.2011;11(1):93-100.
18. Capdevila X, Moulard S, Plasse C, et al. Effectiveness of epiduralanalgesia, continuous surgical site analgesia, and patient-controlledanalgesic morphine for postoperative pain management andhyperalgesia, rehabilitation, and health-related quality of life after opennephrectomy: a prospective, randomized, controlled study. AnesthAnalg. 2017;124(1):336-345.
19. Hosgood SA, Thiyagarajan UM, Nicholson HF, Jeyapalan I, NicholsonML. Randomized clinical trial of transversus abdominis plane blockversus placebo control in live-donor nephrectomy. Transplant.2012;94(5):520-525.
20. Yeap YL, Wolfe JW, Kroepfl E, Fridell J, Powelson JA. Transversusabdominis plane (TAP) block for laparoscopic live donor nephrectomy:continuous catheter infusion provides no additional analgesic benefitover single-injection ropivacaine. Clin Transplant. 2020;34(6):e13861.
21. Sharipova V, Alimov A, Siyabayev F, Sadikov M. Erector spinae planeblock for postoperative analgesia after kidney transplant. Exp ClinTransplant. 2022;20(Suppl 1):83-85.
22. Gritsch HA, Osbun N, Grogan T, et al. Randomized controlled trialof a quadratus lumborum block with liposomal bupivacaine forpostoperative analgesia in laparoscopic donor nephrectomy. ClinTransplant. 2021;35(9):e14403.
23. Petiz C, Barbosa R, Ribeiro Boneco T, Pacheco J, Resende A. Externaloblique intercostal block for living kidney donor open nephrectomy: acase series. Cureus. 2023;15(5):e39139.
24. Bruintjes MH, Braat AE, Dahan A, et al. Effectiveness of deep versusmoderate muscle relaxation during laparoscopic donor nephrectomyin enhancing postoperative recovery: study protocol for a randomizedcontrolled study. Trials. 2017;18(1):99.
25. Lee SH, Lim KC, Jeon MK, et al. Postoperative pain and influencingfactors among living liver donors. Transplant Proc. 2012;44(2):363-365.
26. Cywinski JB, Parker BM, Xu M, Irefin SA. A comparison ofpostoperative pain control in patients after right lobe donorhepatectomy and major hepatic resection for tumor. Anesth Analg.2004;99(6):1747-1752.
27. Yong BH, Tsui SL, Leung CC, et al. Management of postoperativeanalgesia in living liver donors. Transplant Proc. 2000;32(7):2110.
Article available in :
Volume 1, Issue 1, 2024
Page : 1-5
https://doi.org/10.51271/EAJAIC-0001
Article Information
Received : 06 Ara 2023
Accepted : 03 Oca 2024
Published : 12 Şub 2024
Corresponding Author :

Ruslan Abdullayev: Department of Anesthesiology and Reanimation, Faculty of Medicine, Marmara University, İstanbul, Turkiye

[email protected]
Citation : Kelleci Y, Abdullayev R, Bilgili B, Saracoglu A, Umuroğlu T. Epidural versus intravenous analgesia for pain control in kidney donors: a retrospective cohort study. Eur J Anesthesiol Intensive Care. 2024;1(1):1-5.

Read: 147
Cited: 0
Download : 111
_Footer