Continuous flow local anesthetic wound infusion for post-operative analgesia following kidney transplantation
© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd..
BACKGROUND: Some patients with end stage renal disease are or will become narcotic-dependent. Chronic narcotic use is associated with increased graft loss and mortality following kidney transplantation. We aimed to compare the efficacy of continuous flow local anesthetic wound infusion pumps (CFLAP) with patient controlled analgesia pumps (PCA) in reducing inpatient narcotic consumption in patients undergoing kidney transplantation.
MATERIALS AND METHODS: In this single-center, retrospective analysis of patients undergoing kidney transplantation, we collected demographic and operative data, peri-operative outcomes, complications, and inpatient oral morphine milligram equivalent (OME) consumption.
RESULTS: Four hundred and ninety-eight patients underwent kidney transplantation from 2020 to 2022. 296 (59%) historical control patients received a PCA for postoperative pain control and the next 202 (41%) patients received a CFLAP. Median age [53.5 vs. 56.0 years, p = .08] and BMI [29.5 vs. 28.9 kg/m2, p = .17] were similar. Total OME requirement was lower in the CFLAP group [2.5 vs. 34 mg, p < .001]. Wound-related complications were higher in the CFLAP group [5.9% vs. 2.7%, p = .03]. Two (.9%) patients in the CFLAP group experienced cardiac arrhythmia due to local anesthetic toxicity and required lipid infusion.
CONCLUSIONS: Compared to PCA, CFLAP provided a 93% reduction in OME consumption with a small increase in the wound-related complication rate. The utility of local anesthetic pumps may also be applicable to patients undergoing any unilateral abdominal or pelvic incision.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
|---|---|
| Enthalten in: |
Clinical transplantation - 38(2024), 4 vom: 17. Apr., Seite e15305 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Thakker, Parth U [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Analgesics, Opioid |
|---|
| Anmerkungen: |
Date Completed 04.04.2024 Date Revised 18.04.2024 published: Print Citation Status MEDLINE |
|---|
| doi: |
10.1111/ctr.15305 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM370573358 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM370573358 | ||
| 003 | DE-627 | ||
| 005 | 20240419232601.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240404s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/ctr.15305 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1380.xml |
| 035 | |a (DE-627)NLM370573358 | ||
| 035 | |a (NLM)38567895 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Thakker, Parth U |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Continuous flow local anesthetic wound infusion for post-operative analgesia following kidney transplantation |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.04.2024 | ||
| 500 | |a Date Revised 18.04.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: Some patients with end stage renal disease are or will become narcotic-dependent. Chronic narcotic use is associated with increased graft loss and mortality following kidney transplantation. We aimed to compare the efficacy of continuous flow local anesthetic wound infusion pumps (CFLAP) with patient controlled analgesia pumps (PCA) in reducing inpatient narcotic consumption in patients undergoing kidney transplantation | ||
| 520 | |a MATERIALS AND METHODS: In this single-center, retrospective analysis of patients undergoing kidney transplantation, we collected demographic and operative data, peri-operative outcomes, complications, and inpatient oral morphine milligram equivalent (OME) consumption | ||
| 520 | |a RESULTS: Four hundred and ninety-eight patients underwent kidney transplantation from 2020 to 2022. 296 (59%) historical control patients received a PCA for postoperative pain control and the next 202 (41%) patients received a CFLAP. Median age [53.5 vs. 56.0 years, p = .08] and BMI [29.5 vs. 28.9 kg/m2, p = .17] were similar. Total OME requirement was lower in the CFLAP group [2.5 vs. 34 mg, p < .001]. Wound-related complications were higher in the CFLAP group [5.9% vs. 2.7%, p = .03]. Two (.9%) patients in the CFLAP group experienced cardiac arrhythmia due to local anesthetic toxicity and required lipid infusion | ||
| 520 | |a CONCLUSIONS: Compared to PCA, CFLAP provided a 93% reduction in OME consumption with a small increase in the wound-related complication rate. The utility of local anesthetic pumps may also be applicable to patients undergoing any unilateral abdominal or pelvic incision | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a kidney transplantation | |
| 650 | 4 | |a local anesthetic pumps | |
| 650 | 4 | |a narcotics | |
| 650 | 4 | |a opioid use | |
| 650 | 7 | |a Anesthetics, Local |2 NLM | |
| 650 | 7 | |a Analgesics, Opioid |2 NLM | |
| 650 | 7 | |a Narcotics |2 NLM | |
| 700 | 1 | |a Temple, Davis M |e verfasserin |4 aut | |
| 700 | 1 | |a Minnick, Caroline |e verfasserin |4 aut | |
| 700 | 1 | |a Ponzi, Dominick |e verfasserin |4 aut | |
| 700 | 1 | |a Badlani, Gopal |e verfasserin |4 aut | |
| 700 | 1 | |a Hemal, Ashok |e verfasserin |4 aut | |
| 700 | 1 | |a Doares, William |e verfasserin |4 aut | |
| 700 | 1 | |a Webb, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a McCracken, Emily |e verfasserin |4 aut | |
| 700 | 1 | |a Orlando, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Jay, Colleen |e verfasserin |4 aut | |
| 700 | 1 | |a Farney, Alan |e verfasserin |4 aut | |
| 700 | 1 | |a Stratta, Robert J |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical transplantation |d 1987 |g 38(2024), 4 vom: 17. Apr., Seite e15305 |w (DE-627)NLM07493306X |x 1399-0012 |7 nnns |
| 773 | 1 | 8 | |g volume:38 |g year:2024 |g number:4 |g day:17 |g month:04 |g pages:e15305 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/ctr.15305 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 38 |j 2024 |e 4 |b 17 |c 04 |h e15305 | ||