Regional anesthesia for transplantation surgery ‐ A White Paper Part 2: Abdominal transplantation surgery

Author:

Ander Michael1ORCID,Mugve Neal1ORCID,Crouch Cara2ORCID,Kassel Cale3ORCID,Fukazawa Kyota4ORCID,Isaak Robert5ORCID,Deshpande Ranjit6ORCID,McLendon Charles1,Huang Jiapeng7ORCID

Affiliation:

1. Department of Anesthesiology & Perioperative Medicine Loyola University Medical Center Maywood Illinois USA

2. Department of Anesthesiology University of Colorado Anschutz Medical Campus Aurora Colorado USA

3. Department of Anesthesiology Nebraska Medical Center Omaha Nebraska USA

4. Department of Anesthesiology University of Washington School of Medicine Seattle Washington USA

5. Department of Anesthesiology UNC Hospitals N2198 UNC Hospitals Chapel Hill North Carolina USA

6. Department of Anesthesiology Yale University/Yale New Haven Hospital New Haven Connecticut USA

7. Department of Anesthesiology & Perioperative Medicine University of Louisville Louisville Kentucky USA

Abstract

AbstractTransplantation surgery continues to evolve and improve through advancements in transplant technique and technology. With the increased availability of ultrasound machines as well as the continued development of Enhanced Recovery after Surgery (ERAS) protocols, regional anesthesia has become an essential component of providing analgesia and minimizing opioid use perioperatively. Many centers currently utilize peripheral and neuraxial blocks during transplantation surgery, but these techniques are far from standardized practices. The utilization of these procedures is often dependent on transplantation centers’ historical methods and perioperative cultures. To date, no formal guidelines or recommendations exist which address the use of regional anesthesia in transplantation surgery. In response, the Society for the Advancement of Transplant Anesthesia (SATA) identified experts in both transplantation surgery and regional anesthesia to review available literature concerning these topics. The goal of this task force was to provide an overview of these publications to help guide transplantation anesthesiologists in utilizing regional anesthesia. The literature search encompassed most transplantation surgeries currently performed and the multitude of associated regional anesthetic techniques. Outcomes analyzed included analgesic effectiveness of the blocks, reduction in other analgesic modalities—particularly opioid use, improvement in patient hemodynamics, as well as associated complications. The findings summarized in this systemic review support the use of regional anesthesia for postoperative pain control after transplantation surgeries. Part 1 of the manuscript focused on regional anesthesia performed in thoracic transplantation surgeries, and part 2 in abdominal transplantations. Specifically, regional anesthesia in liver, kidney, pancreas, intestinal, and uterus transplants or applicable surgeries are discussed.

Publisher

Wiley

Subject

Transplantation

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