Role of regional anesthesia for placement of peritoneal dialysis catheter under ultrasound guidance: Our experience with 52 end-stage renal disease patients

• Published in: Saudi journal of anaesthesia Vol. 9; no. 2; pp. 132 - 135
• Main Authors: Chatterjee, Smaranjit, Bain, Jayanta, Christopher, Somita, Gopal, Tirupati Venkata Swamy, Raju, Kalidindi Prasad, Mathur, Piyush
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01-04-2015; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Abdomen; Analgesics; Anesthesia; Chronic kidney failure; End stage renal disease; Kidney diseases; Morbidity; Original; Pain; Patients; Peritoneal dialysis; Surgery; transversus abdominis plane block; Ultrasonic imaging; End stage renal disease; peritoneal dialysis; transversus abdominis plane block
• ISSN: 1658-354X; 0975-3125
• DOI: 10.4103/1658-354X.152838

The number of patients with end-stage renal disease (ESRD) has shown a consistent rise in India in recent years. Continuous ambulatory peritoneal dialysis (CAPD) remains one of the safe and effective forms of treatment. In this study, we have tried to assess the effectiveness of field block technique for analgesia during catheter placement surgery until 24 h postoperatively, also, if it can obviate the need for general anesthesia in these high-risk patients.
We studied 52 ESRD patients from 2010 to 2012 who were posted for CAPD catheterization in the Department of Urology, Care Hospital, Hyderabad, India. Under ultrasound guidance, "unilateral posterior" and "unilateral subcostal" transversus abdominis plane block anesthesia were given for the placement of CAPD catheter. Patient's intra-operative pain and post-operative pain were recorded with visual analog scores (VAS) and analyzed.
All patients in our study belonged to American Society of Anesthesiologists category 2 or 3 with multiple co-morbidities. 41 out of 52 patients required no supplemental analgesia during the procedure; 8 patients needed additional infiltration of local anesthetic during skin incisions. Three patients required supplemental analgesia and were considered as failure. A VAS of two was noted in 30 patients and 1 in 19 Patients. No Patient had significant pain 24 h post operatively. No local complication was noted in any patient.
CAPD Catheterization under regional field block remains safe and effective options for ESRD patients.