Ultrasonography-Guided Bilateral Modified Thoracoabdominal Nerve Plane Block With Perichondrial Approach (M-TAPA) For Postoperative Pain Management In Living Liver Donors: Randomized Controlled Study.
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Liver Failure
- Sponsor
- Istanbul Medipol University Hospital
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- Opioid consumption (Fentanyl PCA)
- Status
- Completed
- Last Updated
- last year
Overview
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.
Investigators
Ayse Ince
Assistant Professor
Istanbul Medipol University Hospital
Eligibility Criteria
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
- •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
Outcomes
Primary Outcomes
Opioid consumption (Fentanyl PCA)
Time Frame: 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 Outcomes
- Adverse events(Postoperative 48 hours period)
- Need for rescue analgesia (meperidine)(Postoperative 48 hours period)
- Pain scores (Numerical rating scale-NRS(Changes from baseline pain scores at postoperative 1, 2, 4, 8, 16, 24 and 48 hours])