Implantation of a peritoneal dialysis catheter in patients with ESRD using local anesthesia and Remifentanil

PLoS One. 2021 Nov 4;16(11):e0259351. doi: 10.1371/journal.pone.0259351. eCollection 2021.

Abstract

Study objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Catheterization / adverse effects
  • Catheterization / methods*
  • Feasibility Studies
  • Female
  • Humans
  • Kidney Failure, Chronic / therapy*
  • Male
  • Mepivacaine / administration & dosage*
  • Mepivacaine / adverse effects
  • Middle Aged
  • Peritoneal Dialysis / adverse effects
  • Peritoneal Dialysis / instrumentation
  • Prospective Studies
  • Remifentanil / administration & dosage*
  • Remifentanil / adverse effects
  • Treatment Outcome

Substances

  • Mepivacaine
  • Remifentanil

Grants and funding

The author(s) received no specific funding for this work.