Application of regional methods of pain relief in kidney transplant recipients

Abstract

Aim. Assessing the impact of regional pain management methods on central and peripheral hemodynamics in
the perioperative period.
Material and methods. 97 kidney transplant recipients were divided into 3 groups. In group 1 (31 patients),
general anesthesia (GA) was used. Postoperative pain relief was provided with opioid analgesics in combination
with metamizole. In group 2 (34 patients), a combination of GA and open TAP block (transversus abdominis
plane block) was used. In group 3 (32 patients), a combination of GA and ESPB (erector spinae plane block)
was performed. Opioid analgesics were used as «rescue analgesia» when necessary. The parameters of central
and peripheral hemodynamics were studied: blood pressure, heart rate, SVR, CI, left ventricular myocardial
performance index (LVMPI), as well as the dynamics of glucose, the time of requirement of the first analgesic
(TRFA), the amount of opioid analgesic used in the intra and postoperative period.
Results. The use of ESPB for postoperative pain relief is an effective method of perioperative pain relief; it
helps to reduce the consumption of opioid analgesics in the intraoperative period by 44%, earlier tracheal
extubation by 28%, prolongation of TRFA by 59%, stability of central and peripheral hemodynamics, and a
reduction in the consumption opioid analgesics by 47%, compared to the group with isolated OA anesthesia.
Conclusion. The combined use of GA and ESPB may be recommended in kidney transplant recipients during
the perioperative period of kidney transplantation.