Surgical Approach Affect on Post-operative Analgesic Requirement Following Laparoscopic Nephrectomy
Status:
Completed
Trial end date:
2011-06-01
Target enrollment:
Participant gender:
Summary
Background: We performed this prospective clinical study to compare the post-operative
recovery profile of our patients after transperitoneal and retroperitoneal laparoscopic
nephrectomy techniques. Our primary aim was to compare post-operative epidural analgesic
consumption of transperitoneal (Group T) and retroperitoneal (Group R) laparoscopic
nephrectomy patients within the first 24 hours.
Methods: Forty-four patients scheduled for elective transperitoneal or retroperitoneal
laparoscopic nephrectomies were enrolled. All patients in both groups received epidural
catheter, 2.5ml test dose of lidocaine 2% and general anesthesia induction. At the end of the
surgery, patients were given 1g IV paracetamol and 10ml 0.25% bupivacaine through epidural
catheters and extubated. In the post-operative care unit, 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 by a patient controlled epidural analgesia (PCEA) device. They
were prescribed IV tramadol 1mg/kg as a rescue analgesic (Visual analog scale (VAS)≥4). Total
analgesic consumptions from PCEA devices, VAS scores at rest and during mobilization, heart
rates (HRs), systolic (SBPs)/diastolic blood pressures (DBPs) at extubation (0th min-basal)
and at post-operative 30th min, 2nd, 6th, 12th, 18th and 24th hours as well as number of
patients who require rescue analgesic were recorded. Nausea, vomiting, time to first
mobilization, return of bowel sounds and hospital stay were also documented.