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The analgesic efficacy of Levobupivacaine - Fentanyl via patient-controlledepidural analgesia after renal transplantation
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Tóm tắt
Objective: Evaluating the analgesic effect of patient-controlled epidural analgesia (PCEA) using a mixture of levobupivacaine 0.1% and fentanyl 2 µg/ml after renal transplantation.
Methodology: A prospective, descriptive, longitudinal study was conducted on 50 patients (n=50) over 18 years old (ASA II-IV) who underwent renal transplantation (RT) surgery at 103 Military Hospital from August 2023 to October 2023. The PCEA solution comprised 0.1% levobupivacaine combined with 2 µg/ml fentanyl. Analgesic efficacy was assessed using the Visual Analog Scale (VAS) score both at rest and during movement (coughing) across time points up to 72 hours post-surgery.
Results: The PCEA method provided effective pain control. Mean VAS scores significantly decreased from baseline (H0: 7.1 ± 1.08) to H72 (0.26 ± 0.29 at rest; 0.65 ± 0.49 during movement) (p < 0.001). The average percentage of successful demand requests (A/D ratio) was 85.53 ± 5.48%. Hemodynamic parameters (HR, SBP, MAP) showed statistically significant reductions (p < 0.001) compared to H0 but remained stable within safe clinical limits throughout the monitoring period. The average respiratory rate decreased from 23.90 ± 2.49 breaths/min (H0) to 14.64 ± 1.60 breaths/min (H72). No respiratory depression or motor blockade (100% Bromage M0) was observed. Common adverse drug reactions (ADRs) included nausea/vomiting (16.0%) and itching (12.0%). Patient satisfaction was high, with 88% very satisfied and 12% satisfied.
Conclusion: PCEA utilizing a mixture of levobupivacaine 0.1% and fentanyl 2 µg/ml is a highly effective and satfety method for managing acute postoperative pain after renal transplantation surgery, achieving stable, low VAS scores below the clinically accepted threshold throughout the 72-hour observation period.
Chi tiết bài viết
Từ khóa
Levobupivacaine, Fentanyl, Patient-Controlled Epidural Analgesia, Renal Transplantation, Postoperative Pain
Tài liệu tham khảo
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