Living liver donor pain management.

IF 1.8 4区医学 Q3 TRANSPLANTATION Current Opinion in Organ Transplantation Pub Date : 2023-12-01 Epub Date: 2023-09-07 DOI:10.1097/MOT.0000000000001099

Ryung A Kang, Justin Sangwook Ko

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Abstract

Purpose of review: Optimal pain control in living liver donors undergoing hepatectomy is strongly recommended considering their unique status as healthy individuals willingly undergoing surgery for the benefit of the recipient. This review aims to examine and evaluate different strategies aimed at ensuring effective postoperative pain management in living liver donors.

Recent findings: Enhanced recovery after surgery (ERAS) protocols have proven effective in optimizing patient outcomes, including in living liver donor hepatectomy. By implementing these protocols, healthcare professionals can enhance postoperative pain control and accelerate recovery. Multimodal analgesia, which combines different techniques and agents, is crucial in pain management for living liver donors. Regional analgesia techniques, such as spinal anesthesia and various peripheral nerve blocks, have shown efficacy in reducing pain and facilitating early recovery. Systemic nonopioid analgesics, including acetaminophen, nonsteroidal anti-inflammatory drugs, ketamine, lidocaine, and dexmedetomidine act synergistically to alleviate pain and reduce inflammation. Minimizing the use of opioids is important to avoid adverse effects, and they should be reserved for rescue medication or breakthrough pain.

Summary: Applying the principles of ERAS and multimodal analgesia to living liver donors can effectively control pain while promoting early recovery.

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活体肝脏捐献者疼痛管理。

综述目的：考虑到活体肝脏捐献者作为健康个体的独特地位，为了接受者的利益，他们愿意接受手术，强烈建议对接受肝切除术的活体肝脏捐献者进行最佳疼痛控制。这篇综述旨在检查和评估不同的策略，以确保活体肝脏捐献者术后疼痛的有效管理。最近的发现：手术后增强恢复（ERAS）方案已被证明在优化患者预后方面有效，包括活体肝供体肝切除术。通过实施这些方案，医疗保健专业人员可以加强术后疼痛控制并加速康复。多模式镇痛结合了不同的技术和药物，对活体肝脏捐献者的疼痛管理至关重要。区域镇痛技术，如脊柱麻醉和各种外周神经阻滞，已显示出在减轻疼痛和促进早期康复方面的疗效。包括对乙酰氨基酚、非甾体抗炎药、氯胺酮、利多卡因和右美托咪定在内的全身性非甾体镇痛药协同作用，可减轻疼痛和炎症。尽量减少阿片类药物的使用对于避免不良反应很重要，它们应该保留用于抢救药物或突破性疼痛。总结：将ERAS原理和多模式镇痛应用于活体供肝者，可以有效控制疼痛，促进早期康复。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Organ Transplantation 医学-移植

CiteScore

4.10

自引率

4.50%

发文量

124

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Organ Transplantation is an indispensable resource featuring key, up-to-date and important advances in the field from around the world. Led by renowned guest editors for each section, every bimonthly issue of Current Opinion in Organ Transplantation delivers a fresh insight into topics such as stem cell transplantation, immunosuppression, tolerance induction and organ preservation and procurement. With 18 sections in total, the journal provides a convenient and thorough review of the field and will be of interest to researchers, surgeons and other healthcare professionals alike.

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