Search our Database of Scientific Publications and Authors

I’m looking for a
    Can surgical approach affect postoperative analgesic requirements following laparoscopic nephrectomy: Transperitoneal versus retroperitoneal? A prospective clinical study.
    Arch Esp Urol 2017 Jul;70(6):603-611
    Department of Anesthesiology. Istanbul University. Istanbul Faculty of Medicine.
    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.

    Methods: 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).

    Similar Publications

    The effect of epidural versus general anesthesia on postoperative pain and analgesic requirements in patients undergoing radical prostatectomy.
    Anesthesiology 1994 Jan;80(1):49-56
    Johns Hopkins University School of Medicine, Baltimore, Maryland.
    Background: Although preemptive analgesia has been shown to decrease postinjury pain in animals, studies in humans have provided controversial results. The authors studied whether surgical epidural anesthesia with local anesthetics could affect postoperative pain and analgesic demands, when compared with general anesthesia.

    Methods: Male patients scheduled for radical retropubic prostatectomy were randomly assigned to receive epidural anesthesia only (EA, n = 34), combined epidural and general anesthesia (EG, n = 32), or general anesthesia only (GA, n = 30). Read More
    Patient-controlled epidural analgesia versus continuous epidural analgesia after total knee arthroplasty.
    Acta Anaesthesiol Scand 2001 Apr;45(4):471-6
    Department of Anaesthesia and Intensive Care, Helsinki University Central Hospital, Finland.
    Background: Patient-controlled epidural analgesia (PCEA) has been found to be an effective method for pain relief during labour and after surgery. The goal of this study was to compare the efficacy of bupivacaine-fentanyl PCEA and continuous epidural infusion with the same mixture for treatment of pain after total knee arthroplasty.

    Methods: Fifty-four patients under spinal anaesthesia were allocated to two groups in this randomized, double-blind study: the PCEA group could demand a bolus of 0. Read More
    [Effectiveness of clonidine and fentanyl addition to bupivacaine in postoperative patient controlled epidural analgesia].
    Anasthesiol Intensivmed Notfallmed Schmerzther 2005 Sep;40(9):521-5
    Arzt für Anästhesie, Celal Bayar Universität, Medizinische Fakultät, Abteilung Anästhesiologie.
    Background And Objectives: The aim of this prospective randomized double-blinded study was to compare the analgesic and side-effects of bupivacaine in combination with clonidine or fentanyl during patient-controlled-epidural analgesia (PCEA) in the postoperative period after abdominal hysterectomy.

    Methods: 75 patients from 18 to 65 years of age with ASA status I - II were investigated. After preoperative epidural catheterization, the patients were operated in general anesthesia. Read More
    The effectiveness of patient-controlled epidural analgesia with ropivacaine 0.165% with fentanyl 2.0 miroc g/ml or levobupivacaine 0.125% with fentanyl 2.0 micro g/ml as a method of postoperative analgesia after major orthopaedic surgery.
    Middle East J Anaesthesiol 2013 Feb;22(1):59-64
    Department of Anaesthesia & Intensive Care, Faculty of Medicine, Universiti Teknologi MARA, Sg Buloh Campus, Sg Buloh, Selangor. Malaysia.
    This prospective randomized single-blinded study was conducted to determine whether there were differences in consumption, demand dosing and postoperative analgesia quality between PCEA using ropivacaine and levobupivacaine. Seventy patients with ASA classification I and II aged 18 to 80 years old scheduled for elective total knee replacement or total hip replacement were studied. All patients received CSE and then were randomly allocated to receive either ropivacaine 0. Read More