How painful is donor nephrectomy? Retrospective analysis of early pain and pain management in open versus laparoscopic versus retroperitoneoscopic nephrectomy.
BACKGROUND
The aim of this study was to evaluate the early postoperative pain and pain management after standard open (ODN), hand-assisted laparoscopic (HLDN) and retroperitoneoscopic (RDN) donor nephrectomy.


METHODS
The visual analogue scale (VAS) was determined twice a day in 203 donors during the first five days after nephrectomy.


RESULTS
Mean VAS was significantly lower after RDN and HLDN than after ODN on day 2 (p=0.004) and days 3-5 (p<0.001). After RDN, "no pain" (VAS=0) was reported significantly earlier than after ODN. Irrespective of the technique used and the pain management, all donors reported significantly higher VAS in the morning. Opiates were administered for a significantly shorter average time period after RDN than after ODN (p=0.005). Cumulative morphine equivalent doses were higher after ODN than after RDN (p=0.001). Mean VAS reported after HLDN and RDN was similar.


CONCLUSIONS
In summary, RDN and HLDN were clearly associated with much less early pain than ODN, independently of the used pain management.
Bachmann
Alexander
A
Department of Urology, University Hospital Basel, Basel, Switzerland. bachmanna@uhbs.ch
Wolff
Thomas
T
Giannini
Olivier
O
Dickenman
Michael
M
Ruszat
Robin
R
Gürke
Lorenz
L
Kaufmann
Mark
M
Gasser
Thomas C
TC
Steiger
Jürg
J
Stief
Christian G
CG
Sulser
Tullio
T
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000494:pharmacology / Q000627:therapeutic use; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods*; D010146:Pain / Q000188:drug therapy* / Q000503:physiopathology*; D012189:Retrospective Studies; D013997:Time Factors; D014019:Tissue Donors
D009294:Narcotics