Analgesia after major laparoscopic surgery in patients with chronic kidney disease

A retrospective cohort study

Hey ran Choi, Tak Kyu Oh, Jinhee Kim, Young Tae Jeon

Research output: Contribution to journalArticleResearchpeer-review

Abstract

The amount of reduction in opioid doses and its effect on postoperative pain outcomes in chronic kidney disease (CKD) patients in the perioperative setting remains unclear. This study aimed to investigate differences in postoperative pain outcomes after major laparoscopic surgery between patients with CKD and those with normal preoperative kidney function. Medical records of patients who underwent laparoscopic major abdominal surgery from January 2010 to December 2016 were retrospectively reviewed, and 6,612 patients were finally included. During postoperative day (POD) 0–3, patients with an estimated glomerular filtration rate (eGFR) < 30 mL min −1 1.73 m −2 had 3.5% lower morphine equivalent consumption than those with an eGFR ≥ 90 mL min −1 1.73 m −2 (P = 0.023), whereas patients with preoperative eGFR between 60–90 mL min −1 1.73 m −2 and 30–60 mL min −1 1.73 m −2 showed no significant differences in morphine equivalent consumption. Additionally, pain scores at rest during POD 0–3 were not significantly associated with preoperative kidney function. In conclusion, our results suggest that patients with mild to moderate CKD (stage 2–3) did not require reduction of opioid analgesics during POD 0–3, compared to patients with normal preoperative kidney function. Only patients with severe CKD (stage ≥ 4) might require a slight reduction of opioid analgesics.

Original languageEnglish
Article number3939
Pages (from-to)3939
JournalScientific Reports
Volume9
Issue number1
DOIs
StatePublished - 8 Mar 2019
Externally publishedYes

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Chronic Renal Insufficiency
Laparoscopy
Analgesia
Cohort Studies
Retrospective Studies
Glomerular Filtration Rate
Opioid Analgesics
Postoperative Pain
Kidney
Morphine
Medical Records
Pain

Cite this

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title = "Analgesia after major laparoscopic surgery in patients with chronic kidney disease: A retrospective cohort study",
abstract = "The amount of reduction in opioid doses and its effect on postoperative pain outcomes in chronic kidney disease (CKD) patients in the perioperative setting remains unclear. This study aimed to investigate differences in postoperative pain outcomes after major laparoscopic surgery between patients with CKD and those with normal preoperative kidney function. Medical records of patients who underwent laparoscopic major abdominal surgery from January 2010 to December 2016 were retrospectively reviewed, and 6,612 patients were finally included. During postoperative day (POD) 0–3, patients with an estimated glomerular filtration rate (eGFR) < 30 mL min −1 1.73 m −2 had 3.5{\%} lower morphine equivalent consumption than those with an eGFR ≥ 90 mL min −1 1.73 m −2 (P = 0.023), whereas patients with preoperative eGFR between 60–90 mL min −1 1.73 m −2 and 30–60 mL min −1 1.73 m −2 showed no significant differences in morphine equivalent consumption. Additionally, pain scores at rest during POD 0–3 were not significantly associated with preoperative kidney function. In conclusion, our results suggest that patients with mild to moderate CKD (stage 2–3) did not require reduction of opioid analgesics during POD 0–3, compared to patients with normal preoperative kidney function. Only patients with severe CKD (stage ≥ 4) might require a slight reduction of opioid analgesics.",
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Analgesia after major laparoscopic surgery in patients with chronic kidney disease : A retrospective cohort study. / Choi, Hey ran; Oh, Tak Kyu; Kim, Jinhee; Jeon, Young Tae.

In: Scientific Reports, Vol. 9, No. 1, 3939, 08.03.2019, p. 3939.

Research output: Contribution to journalArticleResearchpeer-review

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