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Regional Analgesia Techniques for Adult Patients Undergoing Solid Organ Transplantation

  • Transplantation Anesthesia (KG Belani, Section Editor)
  • Published:
Current Anesthesiology Reports Aims and scope Submit manuscript

Abstract

Purpose of review

Organ 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 findings

With 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.

Summary

While 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.

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Correspondence to Benjamin Kloesel.

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Benjamin Kloesel and Kamen V. Vlassakov declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Transplantation Anesthesia

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Kloesel, B., Vlassakov, K.V. Regional Analgesia Techniques for Adult Patients Undergoing Solid Organ Transplantation. Curr Anesthesiol Rep 8, 217–224 (2018). https://doi.org/10.1007/s40140-018-0274-5

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