Abstract
With contemporary advances in urologic surgeries, surgical approaches have moved away from open incisions to minimally invasive or robotically guided techniques. Post-operative pain is mainly attributed to the size of the incision, location of port sites, pelvic organ nociception, discomfort due to urinary catheter or diaphragmatic irritation from residual pneumoperitoneum. Multimodal analgesia that centers around use of nerve blocks for renal surgeries has yielded beneficial peri-operative outcomes such as improved functional recovery, reduced incidence of post-operative nausea and vomiting (PONV), all mitigation of adverse effects of opioids. These benefits culminate in shorter hospital lengths of stay, reduced healthcare costs, and increased patient satisfaction.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Chapman E, Pichel AC. Anaesthesia for nephrectomy. BJA Educ. 2016;16(3):98–101. https://doi.org/10.1093/bjaceaccp/mkv022.
Block BM, Liu SS, Rowlingson AJ, Cowan AR, Cowan JA Jr, Wu CL. Efficacy of postoperative epidural analgesia: a meta-analysis. JAMA. 2003;290(18):2455–63. https://doi.org/10.1001/jama.290.18.2455.
Liu SS, Wu CL. Effect of postoperative analgesia on major postoperative complications: a systematic update of the evidence. Anesth Analg. 2007;104(3):689–702. https://doi.org/10.1213/01.ane.0000255040.71600.41.
Manion SC, Brennan TJBR. Thoracic epidural analgesia and acute pain management. Anesthesiology. 2011;115:181–8. https://doi.org/10.1097/ALN.0b013e318220847c.
Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018;5(5):CD000331. https://doi.org/10.1002/14651858.CD000331.pub4.
Halpern S. Recent advances in patient-controlled epidural analgesia for labour. Curr Opin Anaesthesiol. 2005;18(3):247–51. https://doi.org/10.1097/01.aco.0000169229.75938.c8.
Tighe SQM, Greene MD, Rajadurai N. Paravertebral block. Continuing Educ Anaesth Crit Care Pain. 2010;10(5):133–7. https://doi.org/10.1093/bjaceaccp/mkq029.
Karmakar MK. Thoracic paravertebral block. Anesthesiology. 2001;95(3):771–80. https://doi.org/10.1097/00000542-200109000-00033.
Richardson J, Lönnqvist PA. Thoracic paravertebral block. Br J Anaesth. 1998;81(2):230–8. https://doi.org/10.1093/bja/81.2.230.
Kim JW, Kim TW, Ryu KH, Park SG, Jeong CY, Park DH. Anaesthetic considerations for patients with antiphospholipid syndrome undergoing non-cardiac surgery. J Int Med Res. 2020;48(1):300060519896889. https://doi.org/10.1177/0300060519896889.
Horlocker TT, Vandermeuelen E, Kopp SL, Gogarten W, Leffert LR, Benzon HT. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American society of regional anesthesia and pain medicine evidence-based guidelines (fourth edition). Reg Anesth Pain Med 2018;43(3):263–309. doi: https://doi.org/10.1097/AAP.0000000000000763.
Gogarten W, Vandermeulen E, Van Aken H, Kozek S, Llau JV, Samama CM, European Society of Anaesthesiology. Regional anaesthesia and antithrombotic agents: recommendations of the European Society of Anaesthesiology. Eur J Anaesthesiol. 2010;27(12):999–1015. https://doi.org/10.1097/EJA.0b013e32833f6f6f.
Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 2016;41(5):621–7. https://doi.org/10.1097/AAP.0000000000000451.
Elsharkawy H, El-Boghdadly K, Barrington M. Quadratus lumborum block: anatomical concepts, mechanisms, and techniques. Anesthesiology. 2019;130(2):322–35. https://doi.org/10.1097/ALN.0000000000002524.
Corso RM, Piraccini E, Sorbello M, Bellantonio D, Tedesco M. Ultrasound-guided transmuscular quadratus lumborum block for perioperative analgesia in open nephrectomy. Minerva Anestesiol. 2017;83(12):1334–5. https://doi.org/10.23736/S0375-9393.17.12167-X.
Li X, Xu ZZ, Li XY, Jiang TT, Lin ZM, Wang DX. The analgesic efficacy of ultrasound-guided transversus abdominis plane block for retroperitoneoscopic renal surgery: a randomized controlled study. BMC Anesthesiol. 2019;19(1):186. https://doi.org/10.1186/s12871-019-0850-3. PMID: 31627728; PMCID: PMC6800496
Brooks NA, Kokorovic A, McGrath JS, Kassouf W, Collins JW, Black PC, et al. Critical analysis of quality of life and cost-effectiveness of enhanced recovery after surgery (ERAS) for patient’s undergoing urologic oncology surgery: a systematic review. World J Urol. 2020; https://doi.org/10.1007/s00345-020-03341-6.
Kissin I, Weiskopf RB. Preemptive analgesia. Anesthesiology. 2000;93:1138–43. https://doi.org/10.1097/00000542-200010000-00040.
Cantore F, Boni L, Di Giuseppe M, Giavarini L, Rovera F, Dionigi G. Pre-incision local infiltration with levobupivacaine reduces pain and analgesic consumption after laparoscopic cholecystectomy: a new device for day-case procedure. Int J Surg. 2008;6(Suppl 1):S89–92. https://doi.org/10.1016/j.ijsu.2008.12.033.
Ueshima H, Hiroshi O. Incidence of lower-extremity muscle weakness after quadratus lumborum block. J Clin Anesth. 2018;44:104. https://doi.org/10.1016/j.jclinane.2017.11.020.
Wikner M. Unexpected motor weakness following quadratus lumborum block for gynaecological laparoscopy. Anaesthesia. 2017;72(2):230–2. https://doi.org/10.1111/anae.13754.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Pai, P., Abrams, J., Lai, Y.H. (2023). Acute Pain Management Protocol for Urological Procedures: Kidney, Bladder, Prostate. In: Li, J., Jiang, W., Vadivelu, N. (eds) First Aid Perioperative Ultrasound. Springer, Cham. https://doi.org/10.1007/978-3-031-21291-8_29
Download citation
DOI: https://doi.org/10.1007/978-3-031-21291-8_29
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-031-21290-1
Online ISBN: 978-3-031-21291-8
eBook Packages: MedicineMedicine (R0)