TY - JOUR
T1 - Continuous Paravertebral Infusions as an Effective Adjunct for Postoperative Pain Management in Living Liver Donors
T2 - A Retrospective Observational Study
AU - Mistry, K.
AU - Hutchins, Jacob L
AU - Leiting, J.
AU - Mangalick, K.
AU - Pruett, Timothy L
AU - Chinnakotla, Srinath
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2017/3/1
Y1 - 2017/3/1
N2 - We analyzed the effectiveness of paravertebral-block for immediate postoperative pain control in living liver donors. Specifically, we sought to determine whether or not the addition of paravertebral catheters with continuous ropivacaine infusion would decrease postoperative opioid use and reduce the incidence of adverse effects and complications. We reviewed the records of 26 patients who underwent right-lobe living donor hepatectomy (RLDH): 16 with and 10 without such catheters. The primary outcome was opioid use on postoperative day (POD) 1 through 3. For each of those 3 days, we calculated each patient's opioid use in morphine equivalents (mg). We also noted pain scores, adverse effects, and complications. The rate of decrease in morphine equivalents was higher in the catheter group (rate of change = −22.72; P =.038) for POD 1 (0–24 hours) and POD 2 (25–48 hours) than in the noncatheter group. For POD 2 alone, the catheter group used, on average, 20.98 mg fewer morphine equivalents than the noncatheter group (P =.023). The catheter group had a markedly reduced pain trajectory postoperatively (P =.014) than the noncatheter group. The catheter placement procedure itself was safe.
AB - We analyzed the effectiveness of paravertebral-block for immediate postoperative pain control in living liver donors. Specifically, we sought to determine whether or not the addition of paravertebral catheters with continuous ropivacaine infusion would decrease postoperative opioid use and reduce the incidence of adverse effects and complications. We reviewed the records of 26 patients who underwent right-lobe living donor hepatectomy (RLDH): 16 with and 10 without such catheters. The primary outcome was opioid use on postoperative day (POD) 1 through 3. For each of those 3 days, we calculated each patient's opioid use in morphine equivalents (mg). We also noted pain scores, adverse effects, and complications. The rate of decrease in morphine equivalents was higher in the catheter group (rate of change = −22.72; P =.038) for POD 1 (0–24 hours) and POD 2 (25–48 hours) than in the noncatheter group. For POD 2 alone, the catheter group used, on average, 20.98 mg fewer morphine equivalents than the noncatheter group (P =.023). The catheter group had a markedly reduced pain trajectory postoperatively (P =.014) than the noncatheter group. The catheter placement procedure itself was safe.
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U2 - 10.1016/j.transproceed.2016.11.045
DO - 10.1016/j.transproceed.2016.11.045
M3 - Article
C2 - 28219590
AN - SCOPUS:85013159221
SN - 0041-1345
VL - 49
SP - 309
EP - 315
JO - Transplantation proceedings
JF - Transplantation proceedings
IS - 2
ER -