Elsevier

Transplantation Proceedings

Volume 47, Issue 6, July–August 2015, Pages 1896-1900
Transplantation Proceedings

Emerging Perspectives in Transplantation
Liver transplantation
Comparison of Postoperative Analgesic Requirements in Living Donors and Patients Undergoing Similar Surgical Procedures

https://doi.org/10.1016/j.transproceed.2015.04.088Get rights and content

Highlights

  • •

    Donors suffer more postoperative pain than patients.

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    Donors are associated with earlier and more postoperative analgesics administered.

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    Pain management of donors needs to be intensified.

Abstract

Background

More factors affect pain perception of donors than patients. We prospectively evaluated postoperative pain intensity and analgesic requirements in living kidney donors and patients with renal cell carcinoma undergoing laparoscopic nephrectomy with similar surgical procedures.

Material and Methods

The study included 30 living kidney donors and 30 patients with renal cell carcinoma undergoing laparoscopic nephrectomy from March 2013 to August 2014. All of the participants underwent similar surgical procedures under general anesthesia. Data including participants' demographics, surgical data, postoperative analgesic requirements, visual analog scale scores at rest and during coughing at postoperative 0.5, 2, 4, 8, 12, 24, and 48 hours, side effects, and overall satisfaction degree were compared between the 2 groups.

Results

Time to the first tramadol request was significantly shorter in the donors. The donors received more intravenous doses of tramadol than the patients. Visual analog scale scores at 2 and 4 hours at rest and at 2, 4, and 8 hours during coughing after extubation were significantly higher in the donors. There were no significant differences between the groups according to the number of participants given pethidine, time to pethidine rescue, and adverse effects. The overall satisfaction degree was comparable between the 2 groups.

Conclusions

There were significant differences with respect to postoperative pain intensity and analgesic requirements in living kidney donors and patients undergoing retroperitoneal laparoscopic nephrectomy with similar surgical procedures.

Section snippets

Materials and Methods

After approval of the institutional Ethics Committee and written informed consent from the participants, this study enrolled 30 kidney donors (Group D) and 30 patients (Group P) with renal cell carcinoma staged II or below. All participants underwent retroperitoneal laparoscopic nephrectomy with similar surgical procedures. Donors and patients with histories of substance abuse and mental illness, who have allergic reactions to study drugs, with liver or renal dysfunctions, and American Society

Results

Except for intraoperative fluid administration and urine output, which were extremely larger in Group D than in Group P, there were no significant differences between the 2 groups based on demographic data and surgical characteristics (Table 1). There was no need for blood transfusion or conversion to open surgery.

There were significant differences in VAS score at rest at 2 and 4 hours, and during coughing at 2, 4, and 8 hours between Group D and Group P after extubation. VAS scores at these

Discussion

Most laparoscopic nephrectomies are performed through a retroperitoneal approach in our country, not the transperitoneal approach reported in most other countries [2], [3], [4], so the type and intensity of pain are not similar. Part of the external oblique, internal oblique, and transverse muscles, which contribute to body supporting, are dissected in retroperitoneal laparoscopic nephrectomy, therefore, this may cause more pain from the incision than in transperitoneal laparoscopic

References (11)

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