Epidural blockade during liver transplantation

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Abstract

AIM: This study aimed to evaluate the efficacy and safety of epidural analgesia as a component of pain relief on orthotopic liver transplantation.

MATERIALS AND METHODS: Forty-five patients who underwent orthotopic liver transplantation were examined. Epidural and opioid analgesics were used as a component of pain relief in groups 1 (n=24) and 2 (n=21), respectively. The following parameters were evaluated: intensity of postoperative pain, time of patient activation, incidence of postoperative nausea and vomiting, time of onset of enteral nutrition, restoration of bowel function, incidence of postoperative acute respiratory failure, need for opioid analgesics, and length of stay in the intensive care unit (ICU).

RESULTS: Pain intensity and total postoperative need for tramadol and promedol were significantly lower in group 1 than in group 2. During the postoperative period, group 1 showed a decrease in postoperative nausea and vomiting, incidence of postoperative respiratory failure, and time spent in the ICU. No complications with the insertion and removal of the epidural catheter were observed.

CONCLUSION: The use of epidural blockade for liver transplantation significantly reduces the severity of pain syndrome, accelerates the recovery of bowel function, and shortens the length of ICU stay. The use of EA reduces the risk of PONV during the use of opioid analgesics and causes an early start of enteral nutrition. Therefore, epidural analgesics can be used as a component of pain relief in patients undergoing orthotopic liver transplantation.

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About the authors

Vasiliy A. Zhikharev

Scientific Research Institution, Ochapovsky Regional Clinic Hospital N1

Author for correspondence.
Email: Vasilii290873@mail.ru
ORCID iD: 0000-0001-5147-5637
SPIN-code: 7406-7687

MD, Dr. Sci. (Med.)

Russian Federation, 167, 1st May str., Krasnodar, 350081

Alexander S. Bushuev

Scientific Research Institution, Ochapovsky Regional Clinic Hospital N1

Email: Vasilii290873@mail.ru
ORCID iD: 0000-0002-1427-4032
SPIN-code: 3640-7080
Russian Federation, Krasnodar

Movsar U. Khasanov

Scientific Research Institution, Ochapovsky Regional Clinic Hospital N1

Email: Vasilii290873@mail.ru
ORCID iD: 0000-0002-3558-4283
Russian Federation, Krasnodar

Victor A. Koriachkin

St. Petersburg State Pediatric Medical University

Email: vakoryachkin@mail.ru
ORCID iD: 0000-0002-3400-8989
SPIN-code: 6101-0578

MD, Dr. Sci. (Med.), Professor

Russian Federation, St. Petersburg

Vladimir A. Porkhanov

Scientific Research Institution, Ochapovsky Regional Clinic Hospital N1; Kuban state medical university

Email: Vasilii290873@mail.ru
ORCID iD: 0000-0003-0572-1395
SPIN-code: 2446-5933

MD, Dr. Sci. (Med.), Professor

Russian Federation, Krasnodar; Krasnodar

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Supplementary files

Supplementary Files
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1. Fig. 1. Dynamics of mean arterial pressure and heart rate in patients of the 1st group during surgery

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2. Fig. 2. Dynamics of mean arterial pressure and heart rate in patients of the 2nd group during surgery

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3. Fig. 3. Dynamics of pain syndrome in the postoperative period in patients of both groups

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