Management of Pain Post Hepatectomy : Infiltration of Local Anesthetics Versus Continuous Spinal Analgesia .

Management of Pain Post Hepatectomy : Infiltration of Local Anesthetics Versus Continuous Spinal Analgesia .

Analgesia in liver surgery is a challenge, postoperative coagulopathy risk raises fears an epidural haematoma formation following the epidural analgesia, "gold standard" in major abdominal surgery. The spinal analgesia and/or continuous wound infiltration of local anesthetics constitute so an alternative.

The study will compare the continuous infiltration of local anesthetics and rachianalgesia in terms of decreased postoperative morphine consumption and incidences of chronic postoperative pain at 3 and 6 months after hepatic surgery compared to the control group.

Inclusion Criteria:

• Surgery of hepatic resection by first under costal.
• Patient classified ASA 1 to 3.
• Information, signed and informed consent

Exclusion Criteria:

• Patients classified ASA 4 or 5.
• Allergy or intolerance to any of the products used in the protocol.
• Emergency surgery, palliative surgery, surgical recovery.
• History of chronic pain requiring the regular use of analgesics, especially opioids.
• History of drug misuse.
• Inability to understand and / or use the patient's self-controlled morphine pump.
• Known history of psychiatric disorders or current psychotropic treatment (excluding benzodiazepine monotherapy)
• Additive behavior with respect to alcohol or non-weaned psychodysleptic substances
• Pregnant Woman or Breastfeeding