NON-STEROIDAL ANTI-INFLAMMATORY DRUG ADMINISTRATION AND ACUTE KIDNEY INJURY AFTER ROBOTIC ENHANCED RECOVERY PROTOCOL SURGERY

Application of enhanced recovery protocols with robotic surgeries has gained favor across the country because of improved patient recovery times. Acute kidney injury has been found to be the number one postoperative complication for a large, urban trauma center. Use of non-steroidal anti-inflammatory drugs (NSAID) are favored in enhanced recovery protocols (ERP) due to their ability to decrease inflammatory responses associated with surgery and the absence of opioid side effects like respiratory depression, nausea and vomiting, and lack of cognitive effects. NSAIDs reduce the inflammatory response by inhibiting prostaglandin synthesis through inhibition of cyclooxygenase-1 (Cox-1) and cyclooxygenase-2 (Cox-2). Renal prostaglandins are vasodilators in the kidneys and generally do not contribute to regulating renal perfusion except in low perfusion states (Bell et al., 2020). This project is a retrospective, descriptive design looking at the incidence of acute kidney injury (AKI) within the 48-hour postoperative period following the administration of intraoperative non-steroidal anti-inflammatory drugs. The data collection period started in May 2022 and ended in August 2022. Patient and surgical characteristics like age, gender, surgical service, procedure duration, and NSAID dosage were all extracted from the medical record and evaluated. While the findings were not statistically significant across AKI and age, gender, procedure time, or dosage; findings are clinically significant suggesting there could be an increased incidence of AKI in patients greater than 55 years old receiving NSAIDs.