Background and aims The frequency and intensity of postoperative pain in nephrectomy are high. Despite the evidence-based recommendations management for postoperative pain management, the treatment remains suboptimal.
In this study, we compare the safety and efficacy in laparoscopic nephrectomy analgesia between intradural morphine versus serratus intercostal block (SIPB), both of them associated with general anesthesia.
Methods A descriptive and prospective study was conducted in six patients (figure 1), who were scheduled for elective laparoscopic nephrectomy. All patients signed informed consent to entry in the study, which was approved by local Ethics Committee (IP 57/2017).
The patients were randomly allocated to receive either general anesthesia and intradural morphine (0.2 mg) or general anesthesia and SIPB at 8th intercostal level, with 8 ml bupivacaine 0.25%.
Anesthesia in both groups was induced with IV 2 mg/kg propofol, 2 μg/kg fentanyl and muscle relaxation with IV 0.6 mg/kg rocuronium. Following tracheal intubation, 0.1 mg/kg rocuronium was administered when necessary for muscle relaxation. Maintenance anesthesia was established with 2% sevoflurane. Depth of anesthesia was monitored by Sedline, the value of PSI was maintained between 30 and 40. All operations were performed by the same surgical team using the same technique. At the end of the operation, suggammadex (2 mg/kg) iv were applied for the antagonism of the muscle relaxant.
Results All patients reported well-controlled pain at 24 hours postoperatively (table 1).
Conclusions We found similar results in post-operative analgesia (p<0.05 significance) with the two both techniques. SIPB in laparoscopy nephrectomy surgery should be considered.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.