2111 SUB-FASCIAL CONTINUOUS LOCAL ANESTHESIA DRAMATICALLY REDUCES NARCOTIC MEDICATION REQUIREMENTS FOLLOWING LAPARO-ENDOSCOPIC SINGLE SITE DONOR NEPHRECTOMY

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation, Renal Vascular Surgery1 Apr 20132111 SUB-FASCIAL CONTINUOUS LOCAL ANESTHESIA DRAMATICALLY REDUCES NARCOTIC MEDICATION REQUIREMENTS FOLLOWING LAPARO-ENDOSCOPIC SINGLE SITE DONOR NEPHRECTOMY Miguel A. Mercado, Lambros Stamatakis, Shawn Mathur, Judy M. Choi, Edward M. Sanchez, Wesley A. Mayer, and Richard E. Link Miguel A. MercadoMiguel A. Mercado Houston, TX More articles by this author , Lambros StamatakisLambros Stamatakis Houston, TX More articles by this author , Shawn MathurShawn Mathur Houston, TX More articles by this author , Judy M. ChoiJudy M. Choi Houston, TX More articles by this author , Edward M. SanchezEdward M. Sanchez Houston, TX More articles by this author , Wesley A. MayerWesley A. Mayer Houston, TX More articles by this author , and Richard E. LinkRichard E. Link Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Improving pain control after donor nephrectomy may shorten convalescence and reduce barriers to kidney donation. In thoracic and abdominal surgery, sub-fascial continuous local anesthesia (SFCLA) has proven beneficial in reducing the need for narcotic pain medications in the postoperative setting. Herein, we present our experience with SFCLA with laparo-endoscopic single site donor nephrectomy (LESS-DN). METHODS We retrospectively compared all cases of LESS-DN with or without SFCLA performed at our institution by two surgeons (WAM, REL) from October 2011 to August 2012. The On-Q Pain Buster ® with Silver Soaker ™ (I-Flow, Lake Forest CA) catheter system was used for SCFLA. Bilateral catheters were tunneled into the abdominal wall under direct laparoscopic visualization just superficial to the anterior peritoneum. A bolus of 20 mL of 0.5% ropivicaine was administered per catheter, followed by infusion of the same drug at 5 mL/hour from a 725 mL reservoir. The quantity of narcotic pain medicine used +/− SFCLA during the postoperative course was converted to morphine equivalents and compared. Visual analog pain scores at discharge were also recorded. Statistical analysis was performed using the student's t-test. RESULTS Fifty cases of LESS-DN with SCFLA and 77 cases without SCFLA were performed. SCFLA significantly reduced the administered postoperative morphine equivalents by 51% (32.7 mg with SCFLA and 63.2 without SCFLA, p<0.001). No significant differences were noted in hospital length-of-stay or discharge visual analog pain scores between the groups.SCFLA placement increased operative time by 13.6 minutes (p= 0.04). No SCFLA related complications were noted. CONCLUSIONS SFCLA significantly reduces postoperative pain following LESS-DN surgery, as assessed by the amount of narcotic needed to achieve adequate pain control. Although operative time was increased slightly, there were no complications noted. This technique may be valuable in decreasing the perioperative morbidity of laparoscopic donor nephrectomy. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e865 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Miguel A. Mercado Houston, TX More articles by this author Lambros Stamatakis Houston, TX More articles by this author Shawn Mathur Houston, TX More articles by this author Judy M. Choi Houston, TX More articles by this author Edward M. Sanchez Houston, TX More articles by this author Wesley A. Mayer Houston, TX More articles by this author Richard E. Link Houston, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...