Acta anaesthesiologica Scandinavica · 2026
Opioid Consumption After Laparoscopic Radical Nephrectomy in Early Postoperative Recovery Phase: A Retrospective Cohort Study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lilleberg Karla, Vakkala Merja, Kontinen Vesa, Kakko Sanna, Liisanantti Janne, Nurkkala Juho
Аннотация
BACKGROUND: Laparoscopic radical nephrectomy is a relatively common surgical procedure in the treatment of renal cancer and kidney anomalies. Postoperative pain is a major challenge among these patients. Although alternate solutions to conduct analgesia have been researched lately, the pain management of nephrectomy patients still relies on opioids.
METHODS: Retrospective study with 226 patients undergoing elective laparoscopic radical nephrectomy. Epidural, intravenous and oral opioid consumption was recorded during the first 3 postoperative days and factors associated with increased amounts of administered opioids were assessed.
RESULTS: Epidural analgesia was used in 188 (83.2%) of 226 patients and it was associated with increased opioid consumption in all 3 postoperative days. In multivariate analysis the other statistically significant risk factor for increased postoperative opioid consumption during the first 3 postoperative days was female gender, whereas higher BMI negatively correlated with high opioid consumption.
CONCLUSIONS: Based on the results of this study, epidural analgesia was associated with increased opioid consumption after laparoscopic radical nephrectomy. With a more individualized pain management protocol it may be possible to decrease opioid consumption and thus the adverse effects of opioids in this patient group.
EDITORIAL COMMENT: In this retrospective study in postop nephrectomy cases, analgesia with or without appropriate level epidural infusions was delivered, and further pain or analgesia assessment was performed during the first 3 postoperative days. There was an association between epidural analgesia and with more total opioid equivalents administered, though plausible mechanistic explanations for this were unclear.
METHODS: Retrospective study with 226 patients undergoing elective laparoscopic radical nephrectomy. Epidural, intravenous and oral opioid consumption was recorded during the first 3 postoperative days and factors associated with increased amounts of administered opioids were assessed.
RESULTS: Epidural analgesia was used in 188 (83.2%) of 226 patients and it was associated with increased opioid consumption in all 3 postoperative days. In multivariate analysis the other statistically significant risk factor for increased postoperative opioid consumption during the first 3 postoperative days was female gender, whereas higher BMI negatively correlated with high opioid consumption.
CONCLUSIONS: Based on the results of this study, epidural analgesia was associated with increased opioid consumption after laparoscopic radical nephrectomy. With a more individualized pain management protocol it may be possible to decrease opioid consumption and thus the adverse effects of opioids in this patient group.
EDITORIAL COMMENT: In this retrospective study in postop nephrectomy cases, analgesia with or without appropriate level epidural infusions was delivered, and further pain or analgesia assessment was performed during the first 3 postoperative days. There was an association between epidural analgesia and with more total opioid equivalents administered, though plausible mechanistic explanations for this were unclear.