Pain management after small bowel/multivisceral transplantation

Siniscalchi, Antonio; Begliomini, B.; Pietri, Lesley De; Petracca, S. Ivagnes; Braglia, V.; Girardis, Massimo; Pasetto, Alberto; Masetti, Michele; Cautero, N.; Jovine, Elio; Pinna, A.D.

doi:10.1016/s0041-1345(02)02721-5

Cited by 8 publications

(4 citation statements)

References 2 publications

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“…During the perioperative period, fluid and electrolyte management, vasoconstrictor drug use, transfusion of blood and blood products if necessary, and postoperative pain treatment are effective on postreperfusion graft survival (1,2,(6)(7)(8) .…”

Section: Discussionmentioning

confidence: 99%

The effect of perioperative electrolyte, acid-base balance, hemodynamic data and anesthetic management on early mortality of patients with small bowel transplantation

Güntürk¹,

Aydin²,

Karaman³

et al. 2018

Terh

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Objective: Due to high mortality rates, small bowel transplantation is a rarely applied intervention. In this study, we aimed to investigate the effects of perioperative hemodynamic data, electrolyte balance and blood gas parameters on early period mortality of the patients who underwent small bowel transplantation. Methods: The data of 23 patients, who had undergone small bowel transplantation in our clinic between 2004 and 2016, were examined retrospectively. All the patients' demographic data, causes of small bowel syndrome, perioperative hemodynamic data, electrolyte and blood gas values, blood replacement and early postoperative mortality rates within 48 hours were recorded. Statistical analysis was used to identify the parameters that effected early mortality. Results: The mean age of the 23 patients (13 female, and 10 male) was 34.54±15.2 years. Early period mortality was identified in four patients. When comparing demographic and clinic data with mortality, no statistically significant difference was found. There was a significant difference in pH, HCO3, BE values before and after reperfusion. No significant difference was found between electrolyte, blood gas values and early period mortality in the comparison of the same data. Conclusion: Many variables effect mortality in small bowel transplantation patients. We think that hemodynamic and metabolic changes should be monitored carefully in perioperative period to avoid early period mortality. ÖZ Amaç:Yüksek mortalite oranları nedeniyle ince bağırsak transplantasyonu oldukça nadir olarak uygulanan bir girişimdir. Bu çalışmada, ince barsak transplantasyonu uygulanan olguların peroperatif dönemdeki hemodinamik verilerini, elektrolit yönetimini, kan gazı değerlerinin erken dönem mortalite üzerine etkilerini araştırmayı amaçladık. Yöntem: 2004-2016 yılları arasında hastanemiz kliniğimizde ince barsak transplantasyonu operasyonu yapılmış olan 23 hastanın verileri retrospektif olarak incelendi. Tüm hastaların demografik verileri, kısa bağırsak sendromu nedenleri, peroperatif hemodinamik verileri, kan gazı değerleri, kan replasmanı ve postoperatif ilk 48 saat erken dönem mortalite oranları kaydedildi. Mortaliteyi etkileyen parametreleri tanımlamak için istatistiksel analiz yapıldı. Bulgular: Hastaların yaş ortalaması 34,54±15,2 olup, 13'ü kadın, 10'u erkek hastaydı. Erken dönem mortalite toplam 4 hastada gerçekleşti. Mortalite ile demografik ve klinik veriler karşılaştırıldığında istatistiksel olarak fark saptanmadı. Kan gazı ve elektrolit değerlerinin reperfüzyon öncesi ve sonrası karşılaştırılmasında sodyum, pH, HCO3, BE değerleri arasında anlamlı fark vardı. Aynı veriler erken dönem mortalite ile karşılaştırıldığında ise istatistiksel olarak anlamlı fark saptanmadı. Sonuç: İnce bağırsak transplantasyonu yapılan hastalarda mortalite üzerinde birçok değişken mevcuttur. Erken dönem mortaliteyi azaltmak açısından peroperatif dönemde hemodinamik ve metabolik değişikliklerin dikkatle izlenmesi gerektiğini düşünmekteyiz.

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Section: Discussionmentioning

confidence: 99%

The effect of perioperative electrolyte, acid-base balance, hemodynamic data and anesthetic management on early mortality of patients with small bowel transplantation

Güntürk¹,

Aydin²,

Karaman³

et al. 2018

Terh

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“…Additionally, there is modified perception of pain due to psychological effects of chronic bowel disease [74]. Fentanyl and morphine infusions with patient controlled analgesia (PCA) or thoracic epidurals with ropivacaine or bupivacaine with small amounts of opioids have been used for postoperative pain control [74]. It is important to note that pain perception can be extremely variable and unpredictable in these groups of patients.…”

Section: Anesthesia For the Intestinal Transplant Recipientmentioning

confidence: 99%

Intestinal transplantation: The anesthesia perspective

Dalal

2016

Transplantation Reviews

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“…Postoperative pain is lower in patients treated with local anesthetics and opioids administered epidurally than in patients treated with systemic administration of opioids [99,120]. Epidural block and wound infiltration are appropriate techniques for postoperative analgesia also in children [89].…”

Section: Anesthesia In the Perioperative Periodmentioning

confidence: 99%

“…It is necessary to establish a global approach to pain management, including both psychological and medical issues. Postoperative acute pain management should also be coadiuvated by agents with anxiolytic and/or antidepressive activity and a 2 ‐adrenergic agonists (clonidine or dexmetomidine) titrated accordingly to the desired clinical effect and the potential of side effects [120].…”

Section: Anesthesia In the Perioperative Periodmentioning

confidence: 99%

Anesthetic and perioperative management of intestinal and multivisceral allograft recipient in nontransplant surgery

Kostopanagiotou¹,

Sidiropoulou²,

Pyrsopoulos³

et al. 2008

Transplant Int

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Summary As the survival rate of the intestinal and multi‐visceral transplant recipients continues to improve, an increasing number of these patients present for either elective or emergency surgery related or unrelated to transplantation. The aim of this review is to focus on clinical issues related to the anesthetic and perioperative management of the intestinal or multi‐visceral transplant recipient for nontransplant surgery. Specific issues concerning perioperative assessment and medications, choice of anesthetic drugs and techniques, and postoperative care management are reviewed.

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Pain management after small bowel/multivisceral transplantation

Cited by 8 publications

References 2 publications

The effect of perioperative electrolyte, acid-base balance, hemodynamic data and anesthetic management on early mortality of patients with small bowel transplantation

The effect of perioperative electrolyte, acid-base balance, hemodynamic data and anesthetic management on early mortality of patients with small bowel transplantation

Intestinal transplantation: The anesthesia perspective

Anesthetic and perioperative management of intestinal and multivisceral allograft recipient in nontransplant surgery

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