HIỆU QUẢ GIẢM ĐAU ĐA MÔ THỨC SAU PHẪU THUẬT NỘI SOI TRONG VÀ SAU PHÚC MẠC LẤY THẬN GHÉP Ở NGƯỜI HIẾN SỐNG

Abstract

Objectives: To study the analgesic effect on living donors undergoing intra- or retroperitoneal laparoscopic nephrectomy. Methods: A descriptive cross-sectional study on 52 donors who were given multimodal analgesia postoperatively following the same process, including paracetamol, nefopam, and fentanyl PCA (patient-controlled analgesia), and were evaluated for pain level through the VAS (Visual Analog Scale); the amount of fentanyl consumed via PCA. Results: At the time of extubation, 45 (80.36%) kidney donors had VAS < 4; 11 donors (19.64%) had VAS ≥ 4. 100% of donors had VAS < 4 at the postoperative time points (H₀ - H₂₄). There was no difference between the two groups' VAS scores at the moment of extubation and at the postoperative time points (p > 0.05); the average amount of consumed fentanyl for postoperative pain relief within 24 hours via PCA and total were 60.2 and 228.9mcg, respectively. Donors operated on by the intraperitoneal laparoscopic nephrectomy needed more fentanyl than the remaining donors, especially at H₁ (10.3mcg vs. 21.8mcg) and H₂ (23.9mcg vs. 35mcg) (p > 0.05). Conclusion: The multimodal analgesia method, including intravenous paracetamol, nefopam, and fentanyl PCA has good efficacy and is a superior choice in clinical practice, assisting donors in controlling the pain after intraperitoneal or retroperitoneal laparoscopic nephrectomy effectively, safely, and with few complications.