| Background:End-stage renal disease is a common disease, with the incidence rising in recent years. Although conventional methods can improve the patient’s symptoms, the prognosis remains poor. In recent years, living kidney transplantation has been the ideal treatment in patients with end-stage renal disease, which can effectively improve the life quality and prolong life. However, kidney transplant patients have high requirements for anesthesia, for it was the main influence factor to determine the surgical success rates and incidence of postoperative complications. Because of the particular and special pathology and Physiology and pharmacokinetics and pharmacodynamics in end-stage renal disease, the patients have poor tolerance of anesthesia and analgesia. Therefore, choosing the appropriate and reasonable anesthesia and anesthesia medication is of great significance is extremely significant. Recent years, general anesthesia combined with ultrasound-guided trans-abdominal nervous blocking is more and more frequently applied in abdominal surgery, which has been proved to retain good analgesic effect of anesthesia and reduce postoperative opioids. However, there was no study about Ultrasound-guided trans-abdominal nervous blocking in kidney transplants, thus our study aims at elucidate the effectiveness and safety of Ultrasound-guided trans-abdominal nervous blocking in kidney transplantation and evaluate whether exist changes in the analgesic requirements after Renal Transplantation.Objective:To study the effectiveness and safety of Ultrasound-guided trans-abdominal nervous block in kidney transplantation and evaluate whether exist changes in the analgesic requirements after Renal Transplantation.Methods:80 patients (ASA class Ⅱ～Ⅲ grade) undergoing living donor kidney transplant, also the first time kidney transplant, receiving were elected for the study, which was granted by the Ethics Committee of our hospital. All patients were randomly separated into two groups, the experimental group and control group, each with 40 patients. Before induction of general anesthesia, all patients received injection of 20 ml 0.375% ropivacaine and normal saline with same capacity by using ultrasound-guided positioning. Patient-controlled intravenous analgesia of sufentanil was used in postoperative analgesic treatment. The reaction of skin cut, dosage of opioid drug during operation, the VAS score as well as the Ramsay score at the point of operation awake, tube pull, and 2h,6h,12h,24 h after surgery were collected and compared during the study. In addition, the time of first analgesic pump press, times of analgesic pump press, reduction volume of sufentanil within 24 h and the rate of complication were also collected and analyzed. The software of SPSS 16.0 was used for the statistical analysis.Results:Compared with the control group, the blood pressure and heart rate of experimental group obviously reduced (p<0.05); and the VAS score at the point of operation awake, tube pull, and 2h,6h,12h,24h after surgery of experimental group were significantly lower than that in the control group (p<0.05). The Ramsay score at the point of tube pull was obviously better than the control group (p<0.05), while which showed no significantly difference at other time points (p>0.05). The time interval between first and second analgesic pump press in the experimental group was longer than control group (p<0.05), and the times of analgesic pump press and dosage of sufentanil were significantly lower than the control group (p<0.05). There showed no significant differences in SBP, DBP, HR, as well as rate of complication (p>0.05).Conclusion:The injection of 20 ml 0.375% ropivacaine through Ultrasound-guided trans-abdominal nervous block can effectively mitigate the pain of incision during kidney transplantation; Ultrasound-guided TAP block can obviously reduce the reduction of intravenous postoperative analgesic agents, which is safe and effective in renal transplant patients. |
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