Acute pain management after kidney transplantation: A current review of literature

Abstract

Acute postoperative pain management after kidney transplantation is essential for early recovery and good patient satisfaction, but no formal review or guideline is available in the literature. The aim of this review is to make recommendations based on available studies to select the best suitable strategy for pain management. Databases from search engines (PubMed, Scopus, Google Scholar, and Cochrane Library) were thoroughly searched using keywords kidney transplant and pain management or similar. Randomized control trials and retrospective studies with pain scores as primary outcome were included in this review. Out of 1595 articles from electronic database, total 15 articles (prospective studies = 13, retrospective studies, n = 2) were included after deletion of duplicate records, screening of abstracts/titles, and excluding records based on different exclusion criteria. Based on current evidence, intrathecal morphine, epidural analgesia, and fascial plane blocks are suitable options. Paracetamol should be added as a multimodal approach for analgesia. Nonsteroidal anti-inflammatory drugs are best avoided due to the associated risk of renal injury.

Keywords

• acute pain
• end-stage kidney disease
• epidural analgesia
• intrathecal
• kidney transplantation
• pain management