Abstract
Study objectiveThe main objective of this study is to test the feasibility of the local anesthetic (LA) Mepivacaine 1% and sedation with Remifentanil as the primary anesthetic technique for the insertion of a peritoneal dialysis (PD) catheter, without the need to convert to general anesthesia.MethodsWe analyzed 27 consecutive end-stage renal disease (ESRD) patients who underwent the placement of a peritoneal catheter at our center between March 2015 and January 2019. The procedures were all performed by a general or vascular surgeon, and the postoperative care and follow-up were all conducted by the same peritoneal dialysis team.ResultsAll of the 27 subjects successfully underwent the procedure without the need of conversion to general anesthesia. The catheter was deemed prone to usage in all patients and was found to be leak-proof in 100% of the patients.ConclusionThis study describes a safe and successful approach for insertion of a PD catheter by combined infiltration of the local anesthetic Mepivacaine 1% and sedation with Remifentanil. Hereby, ESRD patients can be treated without general anesthesia, while ensuring functionality of the PD catheter.
Highlights
IntroductionThe use of peritoneal dialysis has increased by a rate of 14.5% in developing countries and 30.3% in developed countries [1]
The use of peritoneal dialysis has increased by a rate of 14.5% in developing countries and 30.3% in developed countries [1].Peritoneal dialysis (PD) is the preferred method of dialysis in patients with multiple myeloma, difficulties in fistula generation, coexisting ascites, cardio-renal syndrome, and chronic infections [2]
All of the 27 subjects successfully underwent the procedure without the need of conversion to general anesthesia
Summary
The use of peritoneal dialysis has increased by a rate of 14.5% in developing countries and 30.3% in developed countries [1]. Peritoneal dialysis (PD) is the preferred method of dialysis in patients with multiple myeloma, difficulties in fistula generation, coexisting ascites, cardio-renal syndrome, and chronic infections [2]. PD is beneficial in suitable patients as it facilitates home therapy and increases patient independence [3]. The preserved residual renal function in PD contributes to quality of life and may have additional benefits [4]. Not every patient is eligible for a PD catheter insertion. The insertion of a PD catheter is contraindicated in patients with any form of abdominal hernia, a large surgical scar or previous complicated intra-abdominal surgeries, recurring diverticulitis, or intellectual disability [5]
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