Evaluation of continuous wound infusion with local analgesics in postoperative renal transplantation patients

Abstract

Objectives: The objective is to evaluate the efficacy of the continuous wound infusion (CWI) with Ropivacaine (naropeine 2 mg/ml) on postoperative pain, analgesics consumption, and bowel function in renal transplantation patients. Materials and Methods: A retrospective study trial including 79 patients who underwent renal transplantation. Patients were separated into two groups (catheter or without catheter). We identified 52 (65.8%) patients who received catheter wound infusion during the first 48 h postoperatively. On the other hand, 27 (34.1%) patients received standard without catheter anesthetic technique. Catheter wound infusion was achieved through a 12 cm catheter, inserted subcutaneously after abdominal closure. The catheter was placed above the external oblique aponeurosis. All postoperative data were examined to evaluate the first postoperative 48 h. This study aims to assess three variables: postoperative pain analysis through a visual analog scale, analgesics consumption, and bowel function. Results: The overall score of the three variables was studied. Regarding pain assessment, we have determined that the group of patients with catheter scored better than patients without catheter with borderline significance (66.3 vs. 61.2 consecutively; P = 0.0843). An early bowel function was noted in patients with catheters on the 2nd postoperative day (P = 0.0209). Moreover, patients without catheter consumed more painkillers with nonsignificant difference (P = 0.2499). Conclusion: Patients with catheter showed earlier bowel function than the noncatheter group on the 2nd postoperative day. The catheter group had better pain evaluation.

Abdominal Organ Transplantation: Noteworthy Literature in 2023

“…The authors also demonstrated lower subjective pain scores and lower consumption of analgesics in the experimental group, although these results did not reach statistical significance. 30 Zheng et al conducted a meta-analysis on the use of transversus abdominal plane (TAP) blocks for postoperative analgesia in kidney transplantation. Across 2 retrospective studies and 15 randomized controlled trials (RCTs), the authors found that TAP blocks were associated with significantly lower opioid consumption (mean difference: À11.9 mg morphine equivalent, 95% CI: À17.13 to À6.65) at multiple time points in the postoperative period.…”