{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:19:55Z","timestamp":1753877995794,"version":"3.41.2"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Some patients with end stage renal disease are or will become narcotic\u2010dependent. Chronic narcotic use is associated with increased graft loss and mortality following kidney transplantation. We aimed to compare the efficacy of continuous flow local anesthetic wound infusion pumps (CFLAP) with patient controlled analgesia pumps (PCA) in reducing inpatient narcotic consumption in patients undergoing kidney transplantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>In this single\u2010center, retrospective analysis of patients undergoing kidney transplantation, we collected demographic and operative data, peri\u2010operative outcomes, complications, and inpatient oral morphine milligram equivalent (OME) consumption.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four hundred and ninety\u2010eight patients underwent kidney transplantation from 2020 to 2022. 296 (59%) historical control patients received a PCA for postoperative pain control and the next 202 (41%) patients received a CFLAP. Median age [53.5\u00a0vs. 56.0 years, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.08] and BMI [29.5\u00a0vs. 28.9\u00a0kg\/m<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.17] were similar. Total OME requirement was lower in the CFLAP group [2.5\u00a0vs. 34 mg, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.001]. Wound\u2010related complications were higher in the CFLAP group [5.9%\u00a0vs. 2.7%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.03]. Two (.9%) patients in the CFLAP group experienced cardiac arrhythmia due to local anesthetic toxicity and required lipid infusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared to PCA, CFLAP provided a 93% reduction in OME consumption with a small increase in the wound\u2010related complication rate. The utility of local anesthetic pumps may also be applicable to patients undergoing any unilateral abdominal or pelvic incision.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.15305","type":"journal-article","created":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T12:34:14Z","timestamp":1712147654000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Continuous flow local anesthetic wound infusion for post\u2010operative analgesia following kidney transplantation"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8085-6479","authenticated-orcid":false,"given":"Parth U.","family":"Thakker","sequence":"first","affiliation":[{"name":"Department of Urology Atrium Health Wake Forest Baptist  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davis M.","family":"Temple","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Minnick","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominick","family":"Ponzi","sequence":"additional","affiliation":[{"name":"Wake Forest School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gopal","family":"Badlani","sequence":"additional","affiliation":[{"name":"Department of Urology Atrium Health Wake Forest Baptist  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashok","family":"Hemal","sequence":"additional","affiliation":[{"name":"Department of Urology Atrium Health Wake Forest Baptist  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Doares","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Atrium Health Wake Forest Baptist  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Webb","sequence":"additional","affiliation":[{"name":"Section of Transplantation Department of Surgery Atrium Health Wake Forest Baptist Medical Center  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"McCracken","sequence":"additional","affiliation":[{"name":"Section of Transplantation Department of Surgery Atrium Health Wake Forest Baptist Medical Center  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6460-7974","authenticated-orcid":false,"given":"Giuseppe","family":"Orlando","sequence":"additional","affiliation":[{"name":"Section of Transplantation Department of Surgery Atrium Health Wake Forest Baptist Medical Center  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2552-2617","authenticated-orcid":false,"given":"Colleen","family":"Jay","sequence":"additional","affiliation":[{"name":"Section of Transplantation Department of Surgery Atrium Health Wake Forest Baptist Medical Center  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Farney","sequence":"additional","affiliation":[{"name":"Section of Transplantation Department of Surgery Atrium Health Wake Forest Baptist Medical Center  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7634-094X","authenticated-orcid":false,"given":"Robert J.","family":"Stratta","sequence":"additional","affiliation":[{"name":"Section of Transplantation Department of Surgery Atrium Health Wake Forest Baptist Medical Center  Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,3]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"CDC WONDER.Centers for Disease Control and Prevention.2020. Accessed May 12 2022."},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7006a4"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2021.02.005"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000002057"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14714"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2023.0276"},{"key":"e_1_2_9_8_1","first-page":"1","article-title":"Utilizing multimodal analgesia to evaluate postoperative analgesic requirements in kidney transplant recipients","volume":"4","author":"Muir MA","year":"2021","journal-title":"Clin Transplant."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970-9185.150518"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeq077"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2021.10.049"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.5468\/OGS.2013.56.2.93"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2005.02.011"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aef163"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S144066"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab121"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004389"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.15305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T11:09:51Z","timestamp":1713784191000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.15305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/ctr.15305"],"URL":"https:\/\/doi.org\/10.1111\/ctr.15305","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"type":"print","value":"0902-0063"},{"type":"electronic","value":"1399-0012"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2023-12-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e15305"}}