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Opioid Consumption After Laparoscopic Radical Nephrectomy in Early Postoperative Recovery Phase: A Retrospective Cohort Study

Year: 2025

Type: article

Abstract: BACKGROUND: Laparoscopic radical nephrectomy is a relatively common surgical procedure in the treatment of renal cancer and kidney anomalies. Postoperative pain is a major challenge among these patients. Although alternate solutions to conduct analgesia have been researched lately, the pain management of nephrectomy patients still relies on opioids. METHODS: Retrospective study with 226 patients undergoing elective laparoscopic radical nephrectomy. Epidural, intravenous and oral opioid consumption was recorded during the first 3 postoperative days and factors associated with increased amounts of administered opioids were assessed. RESULTS: Epidural analgesia was used in 188 (83.2%) of 226 patients and it was associated with increased opioid consumption in all 3 postoperative days. In multivariate analysis the other statistically significant risk factor for increased postoperative opioid consumption during the first 3 postoperative days was female gender, whereas higher BMI negatively correlated with high opioid consumption. CONCLUSIONS: Based on the results of this study, epidural analgesia was associated with increased opioid consumption after laparoscopic radical nephrectomy. With a more individualized pain management protocol it may be possible to decrease opioid consumption and thus the adverse effects of opioids in this patient group. EDITORIAL COMMENT: In this retrospective study in postop nephrectomy cases, analgesia with or without appropriate level epidural infusions was delivered, and further pain or analgesia assessment was performed during the first 3 postoperative days. There was an association between epidural analgesia and with more total opioid equivalents administered, though plausible mechanistic explanations for this were unclear.

Source: Acta Anaesthesiologica Scandinavica

DOI: 10.1111/aas.70165

Authors: Karla Lilleberg, Merja Vakkala, Vesa Kontinen, Sanna Kakko, Janne Liisanantti, Juho Nurkkala

Institutions: Oulu University Hospital, University of Oulu, University of Helsinki, Helsinki University Hospital

Language: English

Topic: Anesthesia and Pain Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,430