Case Report: Synchronous Removal and Implantation of Peritoneal Dialysis Catheter Using Bilateral Transversus Abdominis Plane Block

Ante Jakšić; Božidar Vujičić; Diana Deša; Antun Gršković; Ivan Vukelić; Josip Španjol; Sanjin Rački; Dean Markić

doi:10.3389/fmed.2022.828930

Case Report: Synchronous Removal and Implantation of Peritoneal Dialysis Catheter Using Bilateral Transversus Abdominis Plane Block

Front Med (Lausanne). 2022 Mar 1:9:828930. doi: 10.3389/fmed.2022.828930. eCollection 2022.

Authors

Ante Jakšić¹, Božidar Vujičić^{2

3}, Diana Deša⁴, Antun Gršković^{1

3}, Ivan Vukelić¹, Josip Španjol^{1

3}, Sanjin Rački^{2

3}, Dean Markić^{1

3}

Affiliations

¹ Department of Urology, University Hospital Rijeka, Rijeka, Croatia.
² Department of Nephrology, Dialysis and Kidney Transplantation, University Hospital Rijeka, Rijeka, Croatia.
³ Faculty of Medicine, University of Rijeka, Rijeka, Croatia.
⁴ Department of Anesthesiology and Intensive Care, University Hospital Rijeka, Rijeka, Croatia.

Abstract

Background: Peritoneal dialysis (PD) surgery include PD catheter insertion and removal. Both procedures require the use of anesthesia. The end-stage renal disease (ESRD) patients usually have severe comorbidities. The general anesthesia, because of its negative systemic effect, should be omitted in this vulnerable group of the patients. Transversus abdominis plane (TAP) block as a newer method of regional anesthesia is a technique without systemic effect and recently started to be used in ESRD patients for PD catheter placement and/or removal. Here we report a patient in whom we for the first time simultaneously removed and implanted a PD catheter by using a bilateral transversus abdominis plane block.

Case presentation: The patient was an 80-year-old man who was admitted for removal of malfunctioned PD catheter. Since the patient opted for staying on PD simultaneous implantation of catheter was planned. Because of his age and significant comorbidities, general anesthesia was avoided and bilateral TAP block become our option. In the same anesthesia, using bilateral TAP block, the old PD catheter was removed and a new one was implanted. Until now the patient is on regular PD without any complications.

Conclusion: The TAP block could be used as a primary anesthetic technique in ESRD patients for PD surgery even for synchronous removal and implantation of PD catheter.

Keywords: case-reports; end-stage renal disease; peritoneal dialysis catheter; regional anesthesia; transversus abdominis plane (TAP) block.

Publication types

Case Reports