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Role of regional anesthesia for placement of peritoneal dialysis catheter under ultrasound guidance: Our experience with 52 end-stage renal disease patients.

Chatterjee S, Bain J, Christopher S, Gopal TV, Raju KP, Mathur P - Saudi J Anaesth (2015 Apr-Jun)

Bottom Line: In this study, we have tried to assess the effectiveness of field block technique for analgesia during catheter placement surgery until 24 h postoperatively, also, if it can obviate the need for general anesthesia in these high-risk patients.No Patient had significant pain 24 h post operatively.No local complication was noted in any patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Care Hospitals, Hyderabad, Telangana, India.

ABSTRACT

Aim: The number of patients with end-stage renal disease (ESRD) has shown a consistent rise in India in recent years. Continuous ambulatory peritoneal dialysis (CAPD) remains one of the safe and effective forms of treatment. In this study, we have tried to assess the effectiveness of field block technique for analgesia during catheter placement surgery until 24 h postoperatively, also, if it can obviate the need for general anesthesia in these high-risk patients.

Materials and methods: We studied 52 ESRD patients from 2010 to 2012 who were posted for CAPD catheterization in the Department of Urology, Care Hospital, Hyderabad, India. Under ultrasound guidance, "unilateral posterior" and "unilateral subcostal" transversus abdominis plane block anesthesia were given for the placement of CAPD catheter. Patient's intra-operative pain and post-operative pain were recorded with visual analog scores (VAS) and analyzed.

Results: All patients in our study belonged to American Society of Anesthesiologists category 2 or 3 with multiple co-morbidities. 41 out of 52 patients required no supplemental analgesia during the procedure; 8 patients needed additional infiltration of local anesthetic during skin incisions. Three patients required supplemental analgesia and were considered as failure. A VAS of two was noted in 30 patients and 1 in 19 Patients. No Patient had significant pain 24 h post operatively. No local complication was noted in any patient.

Conclusion: CAPD Catheterization under regional field block remains safe and effective options for ESRD patients.

No MeSH data available.


Related in: MedlinePlus

Position of ultrasound sonography transducer in posterior transversus abdominis plane block
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Figure 1: Position of ultrasound sonography transducer in posterior transversus abdominis plane block

Mentions: Once the external oblique, internal oblique and transversus abdomonis muscles were visualized by ultrasound sonography (USG) probe, at the level of anterior axillary line between the 12th rib and the iliac crest the block was performed using an insulated 21 Gauge 10.0 mm needle with an “in plane” technique as illustrated in the Figures 1a–c. Once the tip of the needle was placed in the space between internal oblique and transversus abdominis and negative aspiration confirmed, 20 ml of 0.375% bupivacaine was administered under direct ultrasonographic guidance.


Role of regional anesthesia for placement of peritoneal dialysis catheter under ultrasound guidance: Our experience with 52 end-stage renal disease patients.

Chatterjee S, Bain J, Christopher S, Gopal TV, Raju KP, Mathur P - Saudi J Anaesth (2015 Apr-Jun)

Position of ultrasound sonography transducer in posterior transversus abdominis plane block
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374216&req=5

Figure 1: Position of ultrasound sonography transducer in posterior transversus abdominis plane block
Mentions: Once the external oblique, internal oblique and transversus abdomonis muscles were visualized by ultrasound sonography (USG) probe, at the level of anterior axillary line between the 12th rib and the iliac crest the block was performed using an insulated 21 Gauge 10.0 mm needle with an “in plane” technique as illustrated in the Figures 1a–c. Once the tip of the needle was placed in the space between internal oblique and transversus abdominis and negative aspiration confirmed, 20 ml of 0.375% bupivacaine was administered under direct ultrasonographic guidance.

Bottom Line: In this study, we have tried to assess the effectiveness of field block technique for analgesia during catheter placement surgery until 24 h postoperatively, also, if it can obviate the need for general anesthesia in these high-risk patients.No Patient had significant pain 24 h post operatively.No local complication was noted in any patient.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Care Hospitals, Hyderabad, Telangana, India.

ABSTRACT

Aim: The number of patients with end-stage renal disease (ESRD) has shown a consistent rise in India in recent years. Continuous ambulatory peritoneal dialysis (CAPD) remains one of the safe and effective forms of treatment. In this study, we have tried to assess the effectiveness of field block technique for analgesia during catheter placement surgery until 24 h postoperatively, also, if it can obviate the need for general anesthesia in these high-risk patients.

Materials and methods: We studied 52 ESRD patients from 2010 to 2012 who were posted for CAPD catheterization in the Department of Urology, Care Hospital, Hyderabad, India. Under ultrasound guidance, "unilateral posterior" and "unilateral subcostal" transversus abdominis plane block anesthesia were given for the placement of CAPD catheter. Patient's intra-operative pain and post-operative pain were recorded with visual analog scores (VAS) and analyzed.

Results: All patients in our study belonged to American Society of Anesthesiologists category 2 or 3 with multiple co-morbidities. 41 out of 52 patients required no supplemental analgesia during the procedure; 8 patients needed additional infiltration of local anesthetic during skin incisions. Three patients required supplemental analgesia and were considered as failure. A VAS of two was noted in 30 patients and 1 in 19 Patients. No Patient had significant pain 24 h post operatively. No local complication was noted in any patient.

Conclusion: CAPD Catheterization under regional field block remains safe and effective options for ESRD patients.

No MeSH data available.


Related in: MedlinePlus