Enhanced Recovery After Surgery in Kidney Transplant Donors
Opioid Use, Kidney Diseases, Pain, Postoperative
About this trial
This is an interventional treatment trial for Opioid Use focused on measuring enhanced recovery after surgery, living donor kidney transplant, multimodal analgesia
Eligibility Criteria
Inclusion Criteria:
- All patients undergoing this procedure who consent
Exclusion Criteria:
- patient refusal, female patients who are pregnant or nursing, patients with allergy to local anesthetic, American Society of Anesthesiology classification greater than 3
Sites / Locations
- Thomas Jefferson University HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Enhanced recovery after surgery
Standard of care
Preoperatively, patients will be counseled on optimization of physical and nutritional status. They will receive carbohydrate loading drinks prior to surgery. Intraoperatively, standard ASA monitors will be utilized, and patients will receive general anesthesia. Goal directed fluid management will be enforced with bolus options based on hemodynamics. Transabdominal plane and rectus sheath block will be performed in the operating room by the regional anesthesia team. Post-operatively pain management will include multimodal analgesic medications. Regular diet will be allowed and encouraged on post-operative day 0 (POD). Lines and drains will be minimized to encourage early mobilization and bowel function. Patients will be counseled on expectations of discharge criteria POD0.
Patients will receive traditional care for donor nephrectomy. Patients will be instructed to fast for 24 hours preoperative. On day of surgery, standard monitors will be used, and intraoperative management per anesthesiologists discretion including pain management. Post-operative, patients will receive pain medications, including opioids, as needed. Intravenous fluids will be continued until patients tolerate liquids per os. Bowel regimen will be ordered as needed. Patients will be discharged once meeting pre-set criteria.