Effectiveness of Continuous Low Dose Local Anaesthetic Infusion in Transverses Abdominis Plane (TAP) for Renal Transplant Recipients: A Comparative Study of 157 Patients

Abstract

Introduction: Renal transplant is becoming a gold standard treatment for patients with end stage renal failure. Perioperative management of transplant recipient has much improved over the last two decades. Many efforts have been put in to reduce post operative pain in renal transplant recipients. Currently intravenous opioid administration provides the mainstay of analgesia following renal transplantation. Other techniques including local anaesthetic wound infiltration, transverses abdominis plane (TAP) block and continuous wound infusions have been reported in the literature. This present study describes our experience in multimodal/ opioid sparing analgesia regime with effectiveness of TAP continuous infusion of local anaesthetic in renal transplant recipients and its effects on patient's outcome. Methods: We respectively analysed data of consecutive renal transplant recipients performed between 2009 and 2011. Patients were divided into three groups; Group I (TAP block with continuous TAP catheter infusion and Patient Controlled Analgesia {PCA}, n=43), Group II (Continuous TAP catheter infusion and PCA, n=53) and Group III (PCA only, n=61). Primary outcome was recorded as post-operative pain control. Secondary outcomes were total amount of fentanyl used; post operative wound infection, chest infection, deep venous thrombosis and length of stay in hospital. Medcal software was used for analysis. p < 0.05 was considered statistically significant. Results: Results are shown in Table 1Table: [Outcome analysis]Conclusion: Our results show that TAP continuous infusion of local anaesthetic is an effective method of controlling post-operative pain and minimising opioid use in renal transplant recipients. Although median hospital stay is dependent on many factors but better pain control and early mobility may contribute to the reduction in length of stay.