engleski

Peritoneal dialysis catheter placement using ultrasound-guided transversus abdominis plane block: a pilot study

Objectives: Peritoneal dialysis (PD) catheter placement is performed using several type of anesthesia nowadays. Except general and local anaesthesia, ultrasound-guided regional anesthesia technique can be used for insertion of PD catheter. We present our first exprience with PD catheter placement using ultrasound-guided transversus abdominis plane (TAP) block. Methods. In our pilot study, we prospectively analyzed end stage renal disease patients who underwent PD catheter (straight, double-cuff, Tenckhoff type) placement using a TAP block between June 2011 and April 2013. The correct neurovascular plane was identified using ultrasound. A combined posterior and subcostal approach was used in all patients. PD catheter placement was performed by open surgery. The patients were followed-up for anesthesia-, surgery- and catheter-related complications. Results. We analyzed 15 (9 male, 60%) patients, mean age 57.86±3.09 years. TAP block was performed using 30 mL of 0.5% levobupivacaine hydrochloride for 12/15 (80%) patients or 30 mL of 0.75% ropivacaine for 3/15 (20%) patients, and was successful for 13/15 (86.7%) patients. Two patients (13.3%) had pain at the incision site and required general anesthesia. There were no anaesthesia-, surgery- or catheter- related complications in the first postoperative month. All patients were started on continuous ambulatory peritoneal dialysis four weeks after PD catheter placement. Conclusion. According to our preliminary results, ultrasound-guided TAP block is an effective and safe method of regional anesthesia for PD catheter placement. The future prospective studies with more patients are needed.

peritoneal dialysis; TAP block

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