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I'm preparing a Grand Rounds for next week on Anesthetic Management of Renal Transplantation and trying to focus on areas in which we could improve. After speaking with our transplant nephrologist, one of his biggest issues is the frequency of post-op ileus these patients have due to opioid-based PCAs. A transplant surgeon that left here about a year ago always requested epidurals for his planned transplant patients, but neither of our current surgeons think it's worth it. I personally like the idea, though, and think it would be beneficial.
What is the current practice at your place? If no epidural (e.g., patient is not a candidate for whatever reason), what are your thoughts on TAP blocks for these patients. There's not a whole lot of literature on epidurals or TAPs for renal transplanation.
Sidenote: I also plan to push for using LR instead of (ab)NS for these cases, too. I'm pretty sure that has been discussed on here, as well. Surprisingly, the surgeons said they'd take a look at the articles and consider changing their practice on this.
What is the current practice at your place? If no epidural (e.g., patient is not a candidate for whatever reason), what are your thoughts on TAP blocks for these patients. There's not a whole lot of literature on epidurals or TAPs for renal transplanation.
Sidenote: I also plan to push for using LR instead of (ab)NS for these cases, too. I'm pretty sure that has been discussed on here, as well. Surprisingly, the surgeons said they'd take a look at the articles and consider changing their practice on this.