Comparison of the Postoperative Analgesic Effects of Intrathecal Morphine and Bi-level Erector Spinae Plane Block in Liver Transplantation Donors
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Enrollment
- 60
- Locations
- 1
- Primary Endpoint
- Pain Scores
Study Overview
Brief Summary
Liver transplantation is a life-saving procedure for patients with end-stage liver disease, and postoperative pain management is critical for optimizing donor recovery and overall outcomes. Poorly controlled pain following donor hepatectomy may reduce quality of life, delay mobilization, and contribute to the development of chronic pain syndromes.
Regional anesthesia techniques, such as intrathecal morphine and erector spinae plane block, have been utilized to enhance postoperative analgesia and reduce perioperative opioid requirements, potentially minimizing opioid-related adverse effects.
In this study, we aimed to compare the postoperative analgesic efficacy of intrathecal morphine and Bi-level erector spinae plane block in living liver donors.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Double (Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 65 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients aged 18-65 years
- •American Society of Anesthesiologists (ASA) score I-II
- •Body Mass Index (BMI) between 18-30 kg/m2
Exclusion Criteria
- •Patients under 18 and over 65 years of age
- •ASA score III and above
- •Patients with a history of bleeding diathesis
- •BMI below 18 or above 30 kg/m2
Arms & Interventions
Bi-level Erector Spinae Plane Block
After the linear ultrasound (US) probe will be placed 2-3 cm lateral to the T8 spinous process, 10 ml of 0.25% bupivacaine hydrochloride will be injected cauda-cranially into the interfacial space below the erector spinae muscle, above the transverse process. Next, the needle will be withdrawn till subcutaneously and the linear US probe will be placed 2-3 cm lateral to the T10 spinous process. Finally, 10 ml of 0.25% bupivacaine hydrochloride will be injected cranio-caudally into the interfacial space below the erector spinae muscle, above the transverse process.
This procedure will be performed bilaterally. A total of 40 ml of 0.25% bupivacaine will be injected for bilateral and bi-level ESPB application.
In the intraoperative period, intravenous meperidine 0.5 mg/kg will be given 30min before the end of surgery.
Intervention: Bi-level Erector Spinae Plane Block (Procedure)
Intrathecal Morphine
An intrathecal injection of morphine 300μg will be administered at the L3-L4 or L4-L5 level.
In the intraoperative period, intravenous meperidine 0.5 mg/kg will be given 30min before the end of surgery.
Intervention: Intrathecal Morphine (Procedure)
Outcomes
Primary Outcomes
Pain Scores
Time Frame: On the operation day
Pain will be assessed at rest and while coughing using the visual analog scale on a scale from 0 (no pain) to 10 (worst pain). Pain assessment will be done at 0st, 1st, 2nd,4th, 12th, and 24th hours after surgery.
Secondary Outcomes
- Intraoperative opioid consumption(Intraoperative period)
- Postoperative Opioid Consumption(On the operation day)
Investigators
Atakan Sezgi
Principal Investigator
Ankara Etlik City Hospital