Can surgical approach affect postoperative analgesic requirements following laparoscopic nephrectomy: Transperitoneal versus retroperitoneal? A prospective clinical study.

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 Authors: Savran-Karadeniz M, Kisa I, Salviz EA, Ozkan-Seyhan T, Tefik T, Sanli O, Tugrul KM Abstract 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....
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research

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CONCLUSIONS: Continuous quadratus lumborum type II block was an effective postoperative analgesic option. Blocking of somatic nerves and visceral afferent pathways provided abdominal and visceral wall analgesia, allowing the reduction of opioid consumption. We consider relevant to explore the analgesic capacity of the quadratus lumborum block and its different approaches, as well as the possibility of it becoming an alternative in patients scheduled for kidney surgery. PMID: 29784431 [PubMed - as supplied by publisher]
Source: Revista Brasileira de Anestesiologia - Category: Anesthesiology Tags: Rev Bras Anestesiol Source Type: research
Abstract The incidence of renal cell carcinoma has been rising for years. At the same time there is an increasing prevalence of chronic renal failure with subsequent higher morbidity and shorter life expectancy in those affected. In the last decades the gold standard has thus shifted from radical to partial nephrectomy or tumor enucleation. A treatment alternative can be advantageous for selected patients with high morbidity and an increased risk of complications in anesthesia or surgery. Active surveillance represents a controlled delay in the initiation of treatment with a curative intention. Perc...
Source: Nuklearmedizin - Category: Radiology Authors: Tags: Urologe A Source Type: research
Conclusion: Continuous ETCO2monitoring is a reliable indicator of the trend in arterial CO2fluctuations in the American Society of Anesthesiologists Grades 1 and 2 patients undergoing laparoscopic nephrectomy under general anaesthesia.
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
AbstractRobotic-assisted kidney transplantation (RKT) with the Da Vinci (Intuitive, USA) platform has been recently developed to improve outcomes by decreasing surgical site complications and morbidity, especially in obese patients. This potential paradigm shift in the surgical technique of kidney transplantation is performed in only a few centers. For wider adoption of this high stake complex operation, we aimed to develop a procedure-specific simulation platform in a porcine model for the training of robotic intracorporeal vascular anastomosis and evaluating vascular anastomoses patency. This paper describes the requirem...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research
Abstract Renal cell cancer is nowadays predominantly diagnosed in early stages due to the widespread use of sectional imaging for unrelated symptoms. Small renal masses (
Source: Der Urologe. Ausg. A - Category: Urology & Nephrology Authors: Tags: Urologe A Source Type: research
AbstractPurpose of ReviewLaparoscopic kidney surgery is commonly used for living donor, partial, and total tumor nephrectomy. The successful emergence of laparoscopic technique was justified by the many benefits offered such as reduced blood loss, tissue trauma, pain, and hospital stay. However, this comes at the expense of physiologic changes and complications secondary to pneumoperitoneum, surgical technique, and patient positioning with significant challenges in anesthetic management.Recent FindingsA variety of laparoscopic approaches (transperitoneal, retroperitoneal, hand-assisted, robotic) are used with some having a...
Source: Current Urology Reports - Category: Urology & Nephrology Source Type: research
CONCLUSIONS: There are situations during laparoscopic surgery where a better communication between surgeon and anesthesiologist may improve patient's outcome. Moreover, clinical research has now to identify which additional procedures and type of patients may benefit most from this new deep block concept and ultimately, whether the implementation of a routine deep neuromuscular block may affect patient's outcome. PMID: 29239154 [PubMed - as supplied by publisher]
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
CONCLUSION: AT treatments require patient's comprehension, excellent coordination of the partnership between urologist and radiologist and relevant choices during intervention. PMID: 28942001 [PubMed - as supplied by publisher]
Source: Progres en Urologie - Category: Urology & Nephrology Tags: Prog Urol Source Type: research
Gaurav Sindwani, Sandeep Sahu, Aditi Suri, Zakia SaeedSaudi Journal of Anaesthesia 2017 11(4):513-514
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
ConclusionsPerioperative pregabalin added to a multimodal analgesic regimen was opioid‐sparing, but made no difference to pain intensity score 0–48 h after surgery. Pregabalin may reduce incisional hyperalgesia on the first day after surgery.
Source: Acta Anaesthesiologica Scandinavica - Category: Anesthesiology Authors: Tags: Original Article Source Type: research
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