POSTOPERATIVE ANALGESIA IN KIDNEY TRANSPLANT LAPAROTOMY: QUADRATUS LUMBORUM BLOCK AS AN ALTERNATIVE

2020 ◽  
pp. 33-38
Author(s):  
DITA ADITIANINGSIH ◽  
PRYAMBODHO ◽  
RONALD CHRISTIAN AGUSTINUS ARITONANG ◽  
ERIKA SASHA ADIWONGSO
Keyword(s):  
Kidney Transplantation ◽  
Pain Management ◽  
Kidney Transplant ◽  
Postoperative Analgesia ◽  
Postoperative Pain Management ◽  
Controlled Study ◽  
Transplant Patients ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum ◽  
Postoperative Morphine

Objective: Effective postoperative pain management promotes better recovery. Continuous epidural (CE) is the standard postoperative analgesia for kidney transplantation; however, patients still report pain and unfavorable side effects. This present study compares the effectiveness of quadratus lumborum block (QLB) versus CE for managing pain and reducing morphine requirements following kidney transplantation. Methods: This randomized-controlled study compared 37 kidney transplant patients: a QLB group (N=19) who received 20 ml 0.375% ropivacaine injection bilaterally and a CE group (N=18) who received 0.2% ropivacaine epidurally by infusion at 6 ml/h. Participants were assessed at 2, 6, 12, and 24h postoperatively for morphine requirements and with a visual analogue scale (VAS) for pain while resting and moving. Results: The VAS scores when resting and moving were similar for both QLB and CE at all-time points (p>0.05 for both treatments). Postoperative morphine requirements also did not differ (p>0.05) between the two groups at any time point. Both groups had similar first-time morphine requirements (802.63 min for QLB vs 871.39 min for CE, p=0.814). Both groups achieved 100% blockade at the level of T10–L1 and had comparable Bromage and Ramsay scores. Conclusion: QLB appears to be a viable alternative approach to CE for pain management after kidney transplantation.

scholarly journals Quadratus lumborum block in pediatric patients - a case series

2021 ◽  
pp. 34-34
Author(s):  
Nada Pejcic ◽  
Radomir Mitic ◽  
Ivana Nikolic ◽  
Neeti Sadana ◽  
Ivan Velickovic
Keyword(s):  
Pain Management ◽  
Pediatric Patients ◽  
Open Appendectomy ◽  
Case Series ◽  
Postoperative Pain Management ◽  
Management Plan ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum ◽  
International Teaching ◽  
Perioperative Pain Management

Introduction. The quadratus lumborum block (QLB) was the first interfascial plane block introduced in Leskovac General Hospital thanks to the international teaching Kybele Inc. program in April 2017. Outline of cases. During the period from April 2017 to December 2019, 22 pediatric patients underwent various surgical procedures and had the QLB type 1 block as a part of a multimodal perioperative pain management plan. Unilateral QLB was provided for unilateral inguinal hernia repair, orchidopexy, testicular torsion repair, and open appendectomy. Bilateral QLB was provided for laparoscopic appendectomy and cholecystectomy. Decreased use of fentanyl and sevoflurane was noticed in the cases when QLB was performed preoperatively. All patients had well-controlled pain. Conclusion. QLB is a simple and safe technique. Clear sonographic landmarks allow it to be easily performed. QLB has great potential to improve and facilitate postoperative pain management.

scholarly journals Anaesthesia and Postoperative Analgesia Performed by Insertion of a Perineural Catheter at the Brachial Plexus Site - Case Series

2015 ◽  
Vol 61 (3) ◽  
pp. 241-244
Author(s):  
Lazar Alexandra ◽  
Szederjesi Janos ◽  
Copotoiu Sanda Maria ◽  
Simon Noemi Szidonia ◽  
Badea Iudita ◽  
...  
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Brachial Plexus ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Case Series ◽  
Postoperative Pain Management ◽  
Perineural Catheter ◽  
Plexus Block ◽  
Systemic Drug

Abstract Postoperative pain management is of major importance and the existence of a device that ensures a good analgesia in the immediate postoperative period and also removes the side effects of the systemic drugs, is becoming a necessity. Objectives: The goal was to obtain a good quality anaesthesia and also a good postoperative analgesia by inserting a perineural catheter at the brachial plexus site. Material and method: This study included adult patients who underwent brachial plexus anaesthesia through a perineural catheter inserted at the brachial plexus site. The perineural catheter was introduced by ultrasound guidance with neurostimulation control. After insertion, a quantity of a an-aesthetic admixture of 0.4mg/kg is administered. The anaesthetic admixture contained Ropivacaine and Lidocaine, equimolar concentration of 0.5% In the postoperative period, the analgesia was ensured trough the already installed catheter. The analgesic mixture contained Ropivacaine and Lidocaine, equivalent concentrations of 0.25%. The administration rate was 5 ml every 4 hours, starting 6 hours postoperatively. Results: The anaesthesia, obtained through the perineural catheter, was a good quality anaesthesia ensuring both, good sensory and motor block. The feedback regarding postoperative analgesia was positive, this type of pain management being efficient and without the systemic drug side effects. This approach of brachial plexus block was accepted easily by the patients and was rated as a very satisfactory method. Conclusions: The insertion of a perineural catheter for anaesthesia and postoperative analgesia represents a safe and efficient method of achieving both analgesia and anaesthesia.

scholarly journals Studying Risk Factors Association with Osteoporosis in Post Kidney Transplantation Patients

2020 ◽  
Vol 11 (1) ◽  
pp. 200-206
Author(s):  
Angham Ahmed Hasan ◽  
Munaf H. Zalzala ◽  
Abbas Al-Temimi
Keyword(s):  
Risk Factors ◽  
Kidney Transplantation ◽  
Renal Transplant ◽  
Kidney Transplant ◽  
Female Gender ◽  
Extensive Study ◽  
High Rate ◽  
T Score ◽  
Transplant Patients ◽  
Medical City

Osteoporosis that associate with kidney transplantation is an important cause of ‎morbidity to ‎the patients that warranted extensive study about possible causes of ‎osteoporosis in order to ‎implement several steps to reduce this risk. The current work aimed to investigate possible association between post kidney ‎transplant ‎immunosuppression therapy type and developing the ‎osteoporosis and evaluate the bone mass by using dual X-ray absorptiometry (DXA) post-renalal transplant. A case-control, conducted in kidney transplant center – medical city complex for ‎one year period (‎from October ‎‏2018‏‎ till April 2019), Seventy - five kidney ‎transplant patients were participated in the present study ‎including (21 females & ‎‎54 males). All ‎patients were examined for their bone density using DEXA scan (T – score) and ‎those with cut – point ≤- 2.5 were diagnosed as having osteoporosis (lumber and ‎hip bones were examined). The prevalence of osteoporosis and osteopenia was significantly higher in ‎transplant patients compared to control for bone lumber and hip bone (for ‎lumber bones: 33.3% vs 2.7%l for hip bones: 60% vs. 14.7%). T score was ‎significantly lower in the transplant patients compared to control for both lumber ‎‎(-1.9‎±0.8 vs. -1.1‎±0.7) and hip bones (-2.3‎±0.9 vs -1.3‎±0.8).‎ In logistic regression analysis; only gender and BMI were the predictors of ‎osteoporosis for spinal bone, while; the BMI and calcium were the predictors ‎of osteoporosis for hip bones. In ‏conclusion, Osteoporosis in post-renal transplant patients have a high rate of ‎osteoporosis compared to the general population, post-renal transplant drugs (Cyclosporine, MMF, etc.) did not increase the ‎risk of osteoporosis, and body mass index and female gender were risk factors for osteoporosis

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