Paravertebral Blockade in Kidney Transplantation

Abstract: Single shot paravertebral block (PVB) for
perioperative pain control in patients
undergoing heterotopic kidney
transplantation vs. traditional intravenous
agents with general anesthesia

Methods: 

Retrospective chart review of kidney
transplantation between 1/1/21
3/22/22 of patients who received a PVB
•
Patients were then compared with
historical controls who did not receive
PVB for the same procedure
•
Outcomes: Perioperative pain scores,
opioid consumption, hospital/ICU stay,
blood loss, transfusion requirement.

Results:

No documentation of complication related to performance of the
PVBs.
•
Significant reduction in 24 hour post op OME consumption in the
PVB group [42.2mg (39.1) vs 132.1mg (59.8) P<0.00001].
•
2 patients in the PVB group required ICU admission. One patient
had hypotension requiring treatment and one patient was admitted
for surgical complication.
•
No patients in the control group required ICU admission. Total
hospital length of stay did not differ significantly between groups.

Discussion:

Single shot PVB demonstrates effective perioperative
analgesia, significant reduction in postoperative OME for
surgical kidney transplantation.
•
Comparable safety profile to IV analgesia (blood
loss/transfusion, ICU, mortality)
•
Existing literature remains relatively scarce. RCTs
involving unilateral PVB catheterization ( Yenidunya et al
2017) and single shot thoracic PVB ( Baik et al 2014) for
open nephrectomy corroborate analgesic potential (1,2).