Regional Analgesia Techniques for Adult Patients Undergoing Solid Organ Transplantation

AbstractPurpose of reviewOrgan transplantations often include major incisions that can be associated with significant postoperative pain. While these patients may theoretically benefit from regional anesthesia, many practitioners have avoided such techniques due to considerations, such as a low perceived benefit if the patient stays intubated postoperatively and concerns about the coagulation status in patients with end-stage liver/kidney disease and perioperative use of anticoagulation.Recent findingsWith refinements in both surgical (laparoscopic and robot-assisted procedures) and regional anesthesia techniques (ultrasound guidance), new interest in nerve blocks for organ transplantation has emerged and flourished.SummaryWhile neuraxial anesthesia continues to be used, albeit less frequently for solid organ transplantation, peripheral nerve blocks and paravertebral blocks, in contrast, have increasingly been employed and studied. Specifically, transversus abdominis plane blocks and related fascial plane block techniques are safe to perform and easy to learn. Continuous peripheral nerve blocks are starting to rival the versatility and the widespread use of epidural analgesia with comparable results and lower risk, but validation in various settings is still needed.
Source: Current Anesthesiology Reports - Category: Anesthesiology Source Type: research