Journal of Clinical Medicine
Safety and Analgesic Consumption Impact of Continuous Peripheral Regional Analgesia in Earthquake-Related Crush Injury: A Retrospective Cohort Study
By Özal Adıyeke and Ergün Mendeş.
Abstract
Background
The 6 February 2023 Kahramanmaraş earthquake caused an unprecedented burden of crush-related extremity trauma. Continuous peripheral regional analgesia is frequently used in these patients, but its safety regarding renal outcomes and its effect on systemic opioid consumption have not been quantified in comparative cohort data.
Methods
We conducted a retrospective, exploratory cohort study of 181 hospitalizations (141 patients) following the earthquake, comparing patients who received a continuous peripheral nerve catheter with those managed without one. No prospective sample-size calculation was performed. The primary outcome was acute kidney injury (AKI), defined per adapted KDIGO criteria; the secondary outcome was systemic opioid exposure, assessed both as opioid-days and, in a dose-based sensitivity analysis, as morphine milligram equivalents (MME). Because patients contributed multiple admissions, regression models used cluster-robust standard errors. A propensity-score-matched sensitivity analysis (age, sex) addressed confounding by indication, and intensive care unit (ICU) days were added as a further covariate in sensitivity models.