Mixed anesthesia, continuous epidural plus general balanced for pain management in open nephrectomy. Case report

Abstract

Introduction: Major urological surgery has been described with high rates of postoperative pain. Currently, the patient can be provided with different anesthetic techniques to control pain. Clinical case: The case of a 40-year-old male patient who undergoes right open nephrectomy for severe right hydronephrosis is presented. The use of mixed anesthesia, continuous epidural for pain control and general balanced anesthesia to carry out a surgical procedure is proposed. During the transoperative procedure, analgesia is achieved, and hemodynamic alterations such as hypotension and bradycardia are observed that warrant a pharmacological response with a favorable outcome. In the postoperative period, a visual analgesic scale (VAS) assessment was performed with favorable results for the administration of local anesthetics peridurally, reducing the need for intravenous analgesics. Conclusion: According to the literature, epidural anesthesia for pain control in major abdominal surgeries has been described historically, although there are currently new models of analgesia such as peripheral nerve blocks which must be evaluated to carry out protocols that benefit. to the patient and adverse effects will decrease.