Modified Thoracoabdominal Nerve Plane Block In Living Liver Donors

Not Applicable

Completed

• Conditions: Acute Postoperative Pain; Liver Failure

• Registration Number: NCT06300372
• Lead Sponsor: Istanbul Medipol University Hospital

Brief Summary

Ultrasound-guided Modified Thoracoabdominal Nerve Plane Block (M-TAPA) is performed deep into the costochondral aspect at the 9th-10th costal level by injecting local anesthetics deep into the chondrium. It provides blockage of both the anterior and lateral cutaneous branches of the thoracoabdominal nerve. As there are studies showing M-TAPA block to be effective for postoperative analgesia for other abdominal surgeries, its effect on patients undergoing living liver donor surgery has not been studied yet. We hypothesize that M-TAPA block performed in living liver donors would reduce opioid consumption in the first 48 hours after surgery.

Detailed Description

Open hepatic resection for living liver transplantation donor surgery can cause severe postoperative pain and if not treated properly, may increase the risk of chronic pain development, which has a significant impact on the patient's daily life quality. The use of interfascial plane blocks for pain control has increased in recent years, as ultrasonography (USG) has become a part of daily routine. Interfascial plane blocks provide effective postoperative analgesia. Additionally, reducing postoperative opioid consumption may be a useful strategy to provide hemodynamic stability and promote early mobilization. Case reports state interfascial plane blocks to be effective and safe for providing effective analgesia compared to systemic analgesia in living liver donor surgeries. As studies are showing M-TAPA block to be effective for postoperative analgesia for other abdominal surgeries, its effect on patients undergoing living liver donor surgery has not been studied yet. We hypothesize that the M-TAPA block performed in living liver donors would reduce opioid consumption in the first 48 hours after surgery.

Study Timeline

• Study First Submitted: 2024-03-03
• Study First Submitted QC: 2024-03-03
• Study First Posted: 2024-03-08
• Study Start: 2024-04-01
• Status Verified: 2025-01
• Primary Completion: 2025-01-10
• Study Completion: 2025-01-10
• Last Update Submitted: 2025-01-17
• Last Update Posted: 2025-01-20

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

Patients American Society of Anesthesiologists (ASA) classification I- II Scheduled for living liver donation surgery for liver transplantation under general anesthesia

Exclusion Criteria

Patients

• with history of bleeding diathesis,
• receiving anticoagulant treatment,
• with allergies or sensitivity to drugs used,
• with an infection on the puncture site
• who do not accept the procedure or participate in the study

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Opioid consumption (Fentanyl PCA)	Changes from baseline opioid consumption at postoperative 1, 2, 4, 8, 16, 24 and 48 hours	The primary aim is to compare postoperative opioid consumption from the PCA device.

Secondary Outcome Measures

Name	Time	Method
Adverse events	Postoperative 48 hours period	The secondary aim is to compare the adverse events (nausea, vomiting, itching) related to opioid use.
Need for rescue analgesia (meperidine)	Postoperative 48 hours period	The secondary aim is to compare rescue analgesia used in the postoperative 48 h.
Pain scores (Numerical rating scale-NRS	Changes from baseline pain scores at postoperative 1, 2, 4, 8, 16, 24 and 48 hours]	The secondary aim is to compare NRS at the postoperative 48 h. Postoperative pain assessment will be performed using the NRS (0 = no pain, 10 = the most severe pain felt). The NRS scores will be recorded.

Trial Locations

Locations (1)

Istanbul Medipol University Mega Hospital Complex; 🇹🇷 Istanbul, Bagcilar, Turkey