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Efficacy and safety of continuous local infusion of ropivacaine after retroperitoneoscopic live donor nephrectomy

Biglarnia, A-R LU orcid ; Tufveson, G ; Lorant, T ; Lennmyr, F and Wadström, J (2011) In American Journal of Transplantation 11(1). p.93-100
Abstract

Morphine-based analgesia is effective but can compromise donor safety. We investigated whether continuous infusion of local anesthetics (CILA) can provide sufficient pain control and reduce morbidity related to opiate analgesics after hand-assisted retroperitoneoscopic (HARS) live donor nephrectomy. Forty consecutive live kidney donors underwent HARS and were treated with the ON-Q system providing CILA with 0.5% ropivacaine through two SilvaGard catheters placed in the retroperitoneal cavity and the rectus sheath, respectively. The case control group consisted of 40 donors matched with regard to sex, age, BMI and surgical technique. All donors were maintained on standardized multimodal analgesia combining nurse-controlled oxycodone... (More)

Morphine-based analgesia is effective but can compromise donor safety. We investigated whether continuous infusion of local anesthetics (CILA) can provide sufficient pain control and reduce morbidity related to opiate analgesics after hand-assisted retroperitoneoscopic (HARS) live donor nephrectomy. Forty consecutive live kidney donors underwent HARS and were treated with the ON-Q system providing CILA with 0.5% ropivacaine through two SilvaGard catheters placed in the retroperitoneal cavity and the rectus sheath, respectively. The case control group consisted of 40 donors matched with regard to sex, age, BMI and surgical technique. All donors were maintained on standardized multimodal analgesia combining nurse-controlled oxycodone treatment and acetaminophen. CILA donors had lower median cumulative consumption of morphine equivalents (CCME) (7 mg [0-56] vs. 42 mg [15-127]; p < 0.0000001), lower incidence of nausea (18 [45%] vs. 35 [87.5%] donors; p < 0.001), shorter time in postoperative care unit (160 vs. 242.5 min; p < 0.001) and shorter hospital stay (4 [4-7] vs. 6 [4-11] days; p < 0.001). In 32.5% of CILA donors the CCME was 0 mg (0% in matched control group, p < 0.001). CILA with 0.5% ropivacaine provides effective postoperative pain relief, reduces the need for opioid treatment and promotes postoperative recovery.

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author
; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
Adult, Aged, Amides/administration & dosage, Anesthetics, Local/administration & dosage, Case-Control Studies, Catheters, Female, Humans, Kidney Transplantation/adverse effects, Laparoscopy, Living Donors, Male, Middle Aged, Nephrectomy/adverse effects, Pain, Postoperative/drug therapy, Ropivacaine
in
American Journal of Transplantation
volume
11
issue
1
pages
8 pages
publisher
Elsevier
external identifiers
  • pmid:21199350
  • scopus:78650868417
ISSN
1600-6135
DOI
10.1111/j.1600-6143.2010.03358.x
language
English
LU publication?
no
additional info
©2010 The Authors Journal compilation©2010 The American Society of Transplantation and the American Society of Transplant Surgeons.
id
4b253c06-530c-4296-86f4-e5b2f5fa7351
date added to LUP
2025-12-17 14:20:58
date last changed
2026-01-01 05:19:48
@article{4b253c06-530c-4296-86f4-e5b2f5fa7351,
  abstract     = {{<p>Morphine-based analgesia is effective but can compromise donor safety. We investigated whether continuous infusion of local anesthetics (CILA) can provide sufficient pain control and reduce morbidity related to opiate analgesics after hand-assisted retroperitoneoscopic (HARS) live donor nephrectomy. Forty consecutive live kidney donors underwent HARS and were treated with the ON-Q system providing CILA with 0.5% ropivacaine through two SilvaGard catheters placed in the retroperitoneal cavity and the rectus sheath, respectively. The case control group consisted of 40 donors matched with regard to sex, age, BMI and surgical technique. All donors were maintained on standardized multimodal analgesia combining nurse-controlled oxycodone treatment and acetaminophen. CILA donors had lower median cumulative consumption of morphine equivalents (CCME) (7 mg [0-56] vs. 42 mg [15-127]; p &lt; 0.0000001), lower incidence of nausea (18 [45%] vs. 35 [87.5%] donors; p &lt; 0.001), shorter time in postoperative care unit (160 vs. 242.5 min; p &lt; 0.001) and shorter hospital stay (4 [4-7] vs. 6 [4-11] days; p &lt; 0.001). In 32.5% of CILA donors the CCME was 0 mg (0% in matched control group, p &lt; 0.001). CILA with 0.5% ropivacaine provides effective postoperative pain relief, reduces the need for opioid treatment and promotes postoperative recovery.</p>}},
  author       = {{Biglarnia, A-R and Tufveson, G and Lorant, T and Lennmyr, F and Wadström, J}},
  issn         = {{1600-6135}},
  keywords     = {{Adult; Aged; Amides/administration & dosage; Anesthetics, Local/administration & dosage; Case-Control Studies; Catheters; Female; Humans; Kidney Transplantation/adverse effects; Laparoscopy; Living Donors; Male; Middle Aged; Nephrectomy/adverse effects; Pain, Postoperative/drug therapy; Ropivacaine}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{93--100}},
  publisher    = {{Elsevier}},
  series       = {{American Journal of Transplantation}},
  title        = {{Efficacy and safety of continuous local infusion of ropivacaine after retroperitoneoscopic live donor nephrectomy}},
  url          = {{http://dx.doi.org/10.1111/j.1600-6143.2010.03358.x}},
  doi          = {{10.1111/j.1600-6143.2010.03358.x}},
  volume       = {{11}},
  year         = {{2011}},
}