title: Role of regional anesthesia for placement of peritoneal dialysis catheter under ultrasound guidance: Our experience with 52 end-stage renal disease patients.
abstract: OBJECTIVE
  The number of patients with end-stage renal disease (ESRD) has shown a consistent rise in India in recent years. Continuous ambulatory peritoneal dialysis (CAPD) remains one of the safe and effective forms of treatment. In this study, we have tried to assess the effectiveness of field block technique for analgesia during catheter placement surgery until 24 h postoperatively, also, if it can obviate the need for general anesthesia in these high-risk patients.
  
  
  METHODS
  We studied 52 ESRD patients from 2010 to 2012 who were posted for CAPD catheterization in the Department of Urology, Care Hospital, Hyderabad, India. Under ultrasound guidance, "unilateral posterior" and "unilateral subcostal" transversus abdominis plane block anesthesia were given for the placement of CAPD catheter. Patient's intra-operative pain and post-operative pain were recorded with visual analog scores (VAS) and analyzed.
  
  
  RESULTS
  All patients in our study belonged to American Society of Anesthesiologists category 2 or 3 with multiple co-morbidities. 41 out of 52 patients required no supplemental analgesia during the procedure; 8 patients needed additional infiltration of local anesthetic during skin incisions. Three patients required supplemental analgesia and were considered as failure. A VAS of two was noted in 30 patients and 1 in 19 Patients. No Patient had significant pain 24 h post operatively. No local complication was noted in any patient.
  
  
  CONCLUSIONS
  CAPD Catheterization under regional field block remains safe and effective options for ESRD patients.
authors.affiliation: Department of Urology, Care Hospitals, Hyderabad, Telangana, India.
authors.forename: Smaranjit
authors.initials: S
authors.lastname: Chatterjee
authors.affiliation: Department of Plastic Surgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
authors.forename: Jayanta
authors.initials: J
authors.lastname: Bain
authors.affiliation: Department of Anaesthesiology, Care Hospitals, Hyderabad, Telangana, India.
authors.forename: Somita
authors.initials: S
authors.lastname: Christopher
authors.affiliation: Department of Anaesthesiology, Care Hospitals, Hyderabad, Telangana, India.
authors.forename: Tirupati Venkata Swamy
authors.initials: TV
authors.lastname: Gopal
authors.affiliation: Department of Urology, Care Hospitals, Hyderabad, Telangana, India.
authors.forename: Kalidindi Prasad
authors.initials: KP
authors.lastname: Raju
authors.affiliation: Department of Nephrology, Care Hospitals, Hyderabad, Telangana, India.
authors.forename: Piyush
authors.initials: P
authors.lastname: Mathur
keywords: End stage renal disease; peritoneal dialysis; transversus abdominis plane block
references.citation: Anesth Analg. 2008 Feb;106(2):674-5; author reply 675
references.pmid: 18227342
references.citation: Reg Anesth Pain Med. 2006 Jan-Feb;31(1):91
references.pmid: 16418039
references.citation: Anaesthesia. 2001 Oct;56(10):1024-6
references.pmid: 11576144
references.citation: Br J Anaesth. 2009 Jun;102(6):763-7
references.pmid: 19376789
references.citation: Anaesthesia. 2008 Feb;63(2):211
references.pmid: 18211466