Intertransverse Process Block for Quality of Recovery Post-Open Hepatectomy

Effect of Intertransverse Process Block on the Quality of Recovery Post-Open Hepatectomy: A Pilot Non-Randomised Study of Intervention

The study aims to assess the analgesic efficacy of the ITPB at the retro-SCTL space in patients undergoing major open hepatectomy surgery. This is assessed by:

Primary Objective:

Primary outcome measure:

● Assessing the quality of recovery 15 (QoR15) score at 24 and 48 hours

Secondary outcome measure:

• Number of anaesthetic and hypoesthetic dermatomes on the ventral and dorsal aspect of the thorax on both the sides at 30 minutes of block completion and during the post anaesthetic room (PACU) discharge
• Assessing the 24-hour area under the curve of postoperative pain numerical rating score (NRS, 0-10) at rest and deep breathing or upon use of triflow.
• Assessing the amount of postoperative morphine (mg) equivalent consumption at 24 and 48 hours
• Time to discharge from High dependency unit (HDU) or Intensive care unit (ICU)

Hypothesis:

The investigators hypothesize that the application of ITPB targeting the retro-SCTL space in patients undergoing open hepatectomy will improve overall quality of recovery and pain score.

Inclusion Criteria:

- Adult patients aged 18-75 years of ASA I - III physical status classification undergoing open hepatectomy for benign or malignant liver lesion.

Exclusion Criteria:

• Patient refusal
• Patients who are unable to comprehend the QoR15 form
• Local or systemic infection
• Coagulopathy leading to absolute contraindication to regional anesthesia
• Contraindication to local anaesthetics (LA) such as LA allergy