RESUMEN
OBJECTIVE: The aim of this study was to evaluate the effectiveness of alprazolam, administered at different doses, for the control of adjuvant analgesia in laparoscopic donor nephrectomy patients preoperatively in the Akdeniz University Organ Transplantation Center, using various pain scales. MATERIALS AND METHODS: Only patients with a body mass index ≤28 kg/m2, aged between 18 and 65 years old, and with an American Society of Anesthesiologists score of 1 to 2 were included in the study. The patients were studied in 3 groups, which were given 0.5 mg alprazolam (group 1), 1 mg alprazolam (group 2), or no alprazolam (group 3) in the preoperative period. Collected data were evaluated for preoperative, intraoperative, and postoperative periods. RESULTS: There were 75 patients (31 men, 44 women). Mean age was 43.1 years. Twenty-five patients were evaluated in all 3 groups. Mean operation time was 137.8 minutes. There was no statistical difference among the groups in the duration of administered alprazolam before the operation, on the Ramsey sedation score, verbal pain score, or numeric pain score, and duration of administered first analgesic in the postoperative period. Additional dose of analgesics were administered in 7, 7, and 11 of the patients in group 1, group 2, and group 3, respectively. We found a significant difference between groups 1 and 2 in blood pressure (P = .017 and P = .014). We found a significant difference in group 1 in heart rate (P = .002). CONCLUSION: More effective analgesia protocols need to be identified for pain control in patients of laparoscopic donor nephrectomy. It is thought that the effectiveness of pain control may increase the number of donors and progress in the treatment of patients with renal failure.
Asunto(s)
Alprazolam/administración & dosificación , Analgésicos/administración & dosificación , Nefrectomía/efectos adversos , Manejo del Dolor/métodos , Dolor Postoperatorio/prevención & control , Adolescente , Adulto , Anciano , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Laparoscopía/efectos adversos , Laparoscopía/métodos , Donadores Vivos , Masculino , Persona de Mediana Edad , Nefrectomía/métodos , Cuidados Preoperatorios/métodos , Estudios Retrospectivos , Recolección de Tejidos y Órganos/efectos adversos , Recolección de Tejidos y Órganos/métodos , Adulto JovenRESUMEN
BACKGROUND: Women suffering from kidney disease are more prone to fertility problems, due to uremia. Fortunately, their fertility rate increases dramatically after renal transplantation. This study analyzes the predictors/risk factors of successful pregnancy with live birth outcome while presenting an overview of the 7-year experience of a single center. METHODS: This retrospective cohort study includes 239 women of reproductive age (18-40 years) who underwent renal transplantation in a tertiary Turkish clinic between October 1, 2011, and August 24, 2017. The subjects were invited to take part in a survey questioning their obstetric characteristics and they were assessed in 2 groups: fertile and infertile. Multivariable linear regression analysis was conducted to determine the predictors of a successful pregnancy. RESULTS: Thirty-five 35 patients wished to become pregnant: 12 got pregnant spontaneously, while 21 failed to become pregnant (spontaneously). The mean age of the patients at the survey was 34 ± 7. Regular menstrual cycles after renal transplantation, tacrolimus-mycophenolate mofetil maintenance protocol, and age at transplantation were found to be predictors of spontaneous pregnancy. The duration of peritoneal dialysis was significantly longer in the infertile group (48 vs 12 months). CONCLUSION: End-stage renal disease's negative impacts, including menstrual abnormality and fertility problems, can be overcome by successful kidney transplantation with appropriate immunosuppression. Minimizing the duration of peritoneal dialysis, particularly in patients who desire future fertility, may be accepted as a logical management strategy.