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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intrathecal Morphine | Active Comparator | 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. |
|
| Bi-level Erector Spinae Plane Block | Active Comparator | 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 Next, the needle will be withdrawn till subcutaneously and the linear US probe will be placed 2-3 cm lateral to the T10 spinous process.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. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intrathecal Morphine | Procedure | An intrathecal injection of morphine 300μg will be administered at the L3-L4 or L4-L5 level. Additionally, in the postoperative period a dexketoprofen dose of 50 mg twice daily were administered iv for multimodal analgesia. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Scores | 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. | On the operation day |
| Measure | Description | Time Frame |
|---|---|---|
| Intraoperative opioid consumption | Remifentanil consumption for intraoperative period will be recorded | Intraoperative period |
| Postoperative Opioid Consumption | Opioid consumption for 24 hours will be recorded |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Atakan Sezgi | Contact | 00905323327000 | kansezgi@gmail.com | |
| Jülide Ergil | Contact | 00905323469216 | julideergil@hotmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara Etlik City Hospital | Recruiting | Altındağ | Ankara | 06000 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| Bi-level Erector Spinae Plane Block | Procedure | Bi-level erector spinae plane block will be performed on the patients using a total of 40 ml of 0.25% bupivacaine under ultrasound guidance. Additionally, in the postoperative period a dexketoprofen dose of 50 mg twice daily were administered iv for multimodal analgesia. |
|
| On the operation day |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |