Pain Management in Laparoscopic Living-donor Nephrectomy: The Impact of Erector Spinae Plane Block (ESPB) on Perioperative Period
Condition: Pain, Postoperative; Donor Site Complication
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      Laparoscopic living donor nephrectomy (LLDN) is a safe procedure and rapid wound healing,
      affecting the quality of life. The physiology of postoperative pain after LLDN has been
      attributed to reasons such as tissue damage, residual pneumoperitoneum, and diaphragm
      irritation. In terms of patient comfort after LLDN, pain control is provided by IV
      analgesics, local anesthetic injection instead of incision, and regional techniques. Regional
      anesthesia techniques for postoperative pain control have become popular in recent years.
      Today, many blocks are performed with ultrasonography (USG) to reduce the severity of pain
      after laparoscopic and open surgeries. In 2016, Forero et al. erector spinae plane block
      (ESPB) had been defined and used successfully in thoracic and abdominal surgeries. In our
      clinic, peripheral nerve blocks such as intravenous patient-controlled analgesia (PCA) and
      ESPB are applied for postoperative analgesia. The method of analgesia is suitable for the
      surgery and explained to the patients. This study; In LLDN operations, it was aimed to
      compare the bilateral ESP block performed with USG in terms of postoperative pain scores and
      opioid analgesic consumption compared to patients without any block. Before the operation,
      the anesthesiologist in charge of the anesthesia outpatient clinic provides information about
      both anesthesia and postoperative pain management methods suitable for surgery. This is the
      standard practice in our clinic. Before anesthesia, anesthesia and analgesia methods will be
      briefly reminded to the patient who has come for the operation. He/she will be asked if
      he/she wants to apply postoperative analgesia. Block procedure will be applied to patients
      who want ESP block. Standard analgesia will be applied to all patients. Regardless of the
      study, patients who underwent LLDN operation will be interviewed in the postoperative period
      with or without an ESP block for postoperative analgesia. The data and postoperative
      evaluations of the patients who agreed to participate in the study will be recorded for study
      purposes. The patient data will be taken from the hospital registration system.
    


Intervention name(s): NAS score
Intervention type(s): Diagnostic Test
Intervention description(s): Participants will be recorded according to the NAS and W-BAS pain scores
Other intervention name(s): W-BAS score
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: After the application of the ESPB was explained to the volunteers, a block was applied if the patients provided their consent. The donors were randomly assigned to Group B (ESPB group) or Group C (control group) using computer-generated random numbers placed in separate closed envelopes that the study investigator opened before performing the block in the operation room.
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: pain management; laparoscopic living-donor nephrectomy; erector spinae plane block