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ESRA19-0221 Perioperative nephrectomy management: intradural morphine versus serratus intercostal block
  1. R López Herrero,
  2. MA Pérez Herrero,
  3. B Sánchez Quirós,
  4. A Martinez Martin,
  5. O De la Varga Martinez and
  6. S Cocho Crespo
  1. Hospital Clinico Universitario, Anestesia y Reanimación, Valladolid, Spain


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).

Abstract ESRA19-0221 Figure 1

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).

Abstract ESRA19-0221 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.

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