Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Department of Anesthesiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
PLoS One. 2021 Nov 4;16(11):e0259351. doi: 10.1371/journal.pone.0259351. eCollection 2021.
The main objective of this study is to test the feasibility of the local anesthetic (LA) Mepivacaine 1% and sedation with Remifentanil as the primary anesthetic technique for the insertion of a peritoneal dialysis (PD) catheter, without the need to convert to general anesthesia.
We analyzed 27 consecutive end-stage renal disease (ESRD) patients who underwent the placement of a peritoneal catheter at our center between March 2015 and January 2019. The procedures were all performed by a general or vascular surgeon, and the postoperative care and follow-up were all conducted by the same peritoneal dialysis team.
All of the 27 subjects successfully underwent the procedure without the need of conversion to general anesthesia. The catheter was deemed prone to usage in all patients and was found to be leak-proof in 100% of the patients.
This study describes a safe and successful approach for insertion of a PD catheter by combined infiltration of the local anesthetic Mepivacaine 1% and sedation with Remifentanil. Hereby, ESRD patients can be treated without general anesthesia, while ensuring functionality of the PD catheter.
本研究的主要目的是测试局部麻醉（LA）甲哌卡因 1%和瑞芬太尼镇静作为腹膜透析（PD）导管插入的主要麻醉技术的可行性，而无需转换为全身麻醉。
我们分析了 2015 年 3 月至 2019 年 1 月期间在我们中心接受腹膜导管放置的 27 例终末期肾病（ESRD）患者。这些手术均由普外科或血管外科医生进行，术后护理和随访均由同一腹膜透析团队进行。
所有 27 例患者均成功完成手术，无需转换为全身麻醉。所有患者的导管均易于使用，100%的患者均无渗漏。
本研究描述了一种安全且成功的方法，通过局部麻醉甲哌卡因 1%浸润和瑞芬太尼镇静联合使用，可插入 PD 导管。通过这种方法，ESRD 患者可以在不接受全身麻醉的情况下得到治疗，同时确保 PD 导管的功能。
