Can surgical approach affect postopertive analgesic requirements following laparoscopic nephrectomy: transperitoneal versus retroperitoneal? A prospective clinical study / ¿Puede el abordaje quirúrgico afectar a la necesidad de analgésicos postoperatorios después de nefrectomía laparoscópica?: Nefrectomía Transperitoneal versus Retroperitoneal. Un estudio clínico prospectivo
Savran-Karadeniz, Meltem; Kisa, Ilkay; Salviz, Emine-Aysu; Ozkan-Seyhan, Tulay; Tefik, Tzevat; Sanli, Oner; Tugrul, Kamil-Mehmet.
Arch. esp. urol. (Ed. impr.)
; 70(6): 603-611, jul.-ago. 2017. tab, graf
Artigo
Inglês
| IBECS (Espanha) | ID: ibc-164569
OBJECTIVES:
We performed this prospective clinical study to compare the postoperative recovery profile of our patients after transperitoneal (Group T) and retroperitoneal (Group R) laparoscopic nephrectomy approaches. Our primary hypothesis was that epidural analgesic consumption in Group R would be higher at the end of the first postoperative day. Methodos Forty-four patients scheduled for elective transperitoneal or retroperitoneal laparoscopic nephrectomies were enrolled. All patients in both groups received epidural catheter and general anesthesia induction. At the end of the operation, patients were given 10 ml 0.25% bupivacaine through epidural catheters and extubated. Postoperatively, patients started to receive a continuous infusion of 0.1% bupivacaine and 1μg/ml fentanyl 5ml/h with patient- controlled boluses of an additional 4ml through a patient controlled epidural analgesia (PCEA) device. They were prescribed IV tramadol 1mg/kg as a rescue analgesic (VAS≥4). Total analgesic consumption from PCEA devices and VAS scores during the first 24 postoperative hours were recorded as well as number of patients who required analgesic rescue.RESULTS:
Forty patients completed the study, 20 in each group. Total epidural analgesic consumption during the first 12 hours were significantly higher in Group R (p < 0.05). Basal, postoperative 30 min, 2, 6 hours VASrest, VASmobilization and 12 h VASmobilization scores, and number of patients who required rescue analgesic at 0, 30 min in Group R were significantly higher than Group T (p < 0.05).CONCLUSION:
Retroperitoneal laparoscopic nephrectomy was found to be more painful and patients in this group required more epidural and analgesic rescue during the first 12 postoperative hours. ClinicalStudys.gov (NCT02622893)
Biblioteca responsável:
ES1.1
Localização: BNCS
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