Kocaeli Med J. 2024; 13(1): 41-45 | DOI: 10.5505/ktd.2024.66742

Advantage of Epidural Analgesia in Living Donor Hepatectomy, a Retrospective Cohort Study

Ruslan Abdullayev¹, Yavuz Kelleci¹, Beliz Bilgili¹, Ayten Saraçoðlu², Tumay Umuroðlu^1
1Marmara University Department of Anesthesiology and Reanimation, Istanbul, Turkey
²Qatar University College of Medicine Department of Anesthesiology, Doha, Qatar

INTRODUCTION: Control of postoperative pain in live liver donor patients is extremely important in terms of both patient comfort and reducing morbidity. The aim of this retrospective cohort study was to compare intravenous (IV) and epidural-based analgesia methods in live liver donor patients in terms of postoperative pain levels, analgesic, and antiemetic consumption.
METHODS: After ethics committee approval, the data of the liver transplantation donors obtained within a period of seven years in our clinic were examined. Demographic data, surgical and clinical characteristics, postoperative pain scores, analgesic and antiemetic consumption of the patients were obtained from the records and files. The patients were classified according to the use of intravenous and epidural-based analgesia methods, and their demographic and clinical characteristics, intraoperative opioid consumptions, postoperative pain scores, postoperative analgesic and antiemetic use amounts were compared. SPSS software was used to analyze the data.
RESULTS: A total of 28 patients' data were obtained, five of which were in the IV group and 23 in the epidural group. Perioperative opioid consumption was significantly higher in the IV group (P = 0.009). There was a trend for lower postoperative pain scores in the epidural group. Rescue analgesic use on the second postoperative day was significantly higher in the IV group (P <0.041).
DISCUSSION AND CONCLUSION: Postoperative pain control is better with epidural analgesia in live liver donor patients. Patients with epidural analgesia have lower intraoperative opioid consumption, tend to have lower postoperative pain scores, and less rescue analgesic consumption on the second postoperative day.

Keywords: patient-controlled analgesia, PCA, intravenous, liver, postoperative pain

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Canlý Donör Hepatektomide Epidural Analjezinin Avantajý, Retrospektif Kohort Çalýþma

Ruslan Abdullayev¹, Yavuz Kelleci¹, Beliz Bilgili¹, Ayten Saraçoðlu², Tumay Umuroðlu^1
1Marmara Üniversitesi Anesteziyoloji ve Reanimasyon Bölümü, Ýstanbul, Türkiye
²Katar Üniversitesi Týp Fakültesi Anesteziyoloji Bölümü, Doha, Katar

GÝRÝÞ ve AMAÇ: Canlý karaciðer donörü hastalarýnda postoperatif aðrýnýn kontrolü hem hasta konforu hem de morbiditenin azaltýlmasý açýsýndan son derece önemlidir. Bu retrospektif kohort çalýþmamýzýn amacý canlý karaciðer vericisi hastalarýnda intravenöz (IV) ve epidural temelli analjezi yöntemlerini hastalarýn postoperatif aðrý düzeyleri, analjezik ve antiemetik tüketimi açýsýndan karþýlaþtýrmaktý.
YÖNTEM ve GEREÇLER: Etik kurul onayý alýndýktan sonra kliniðimizde yedi yýllýk süre içinde alýnan karaciðer transplantasyon vericisinin verileri incelenmiþtir. Hastalarýn demografik verileri, cerrahi ve klinik özellikleri, postoperatif aðrý skorlarý, analjezik ve antiemetik tüketimleri kayýtlardan ve dosyalardan elde edildi. Hastalar intravenöz ve epidural temelli analjezi yöntemi kullanýmýna göre sýnýflandýrýlmýþ olup, demografik ve klinik özellikleri, intraoperatif opioid tüketimleri, postoperatif aðrý skorlarý, postoperatif analjezik ve antiemetik kullaným miktarlarý karþýlaþtýrýldý. Verilerin incelenmesinde SPSS yazýlýmý kullanýldý.
BULGULAR: Toplamda 28 hastanýn verisi elde edilmiþ olup, bunlardan beþi IV grupta, 23’ü ise epidural gruptaydý. Perioperatif opioid tüketimi IV grupta anlamlý olarak daha yüksekti (P = 0.009). Epidural grupta daha düþük postoperatif aðrý skorlarý eðilimi vardý. Postoperatif ikinci günde kurtarýcý analjezik kullanýmý IV grupta anlamlý olarak daha yüksekti (P <0.041).
TARTIÞMA ve SONUÇ: Canlý karaciðer vericisi hastalarýnda postoperatif aðrý kontrolü epidural analjezi ile daha iyi saðlanmaktadýr. Epidural analjezi uygulanan hastalarda daha düþük intraoperatif opioid tüketimi, daha düþük postoperatif aðrý skorlarý, postoperatif ikinci günde daha az kurtarýcý analjezik tüketimi eðilimi olmaktadýr.

Anahtar Kelimeler: hasta kontrollü analjezi, HKA, intravenöz, karaciðer, postoperatif aðrý

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