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Postoperative pain control plays a crucial role in enhancing recovery and improving early mobilization in living liver donors. The rectus-intercostal fascial plane (RIFP) block is a novel ultrasound-guided regional anesthesia technique that provides anterior abdominal wall analgesia by targeting the intercostal nerves between the rectus abdominis and intercostal muscle fascia.
This prospective, randomized controlled clinical study aims to evaluate the postoperative analgesic efficacy and opioid-sparing effects of the RIFP block compared with standard intravenous analgesia in living liver donors undergoing donor hepatectomy.
Participants will be randomly assigned to two groups:
Group 1 (RIFP Block): Patients receiving an ultrasound-guided rectus-intercostal fascial plane block using 20 mL of 0.25% bupivacaine at the end of surgery, in addition to standard IV PCA (morphine).
Group 2 (Control): Patients receiving only standard IV PCA (morphine) without regional block.
This prospective randomized controlled study will include living liver donors undergoing donor hepatectomy. Participants will be divided into two groups: the Rectus-Intercostal Fascial Plane (RIFP) Block Group and the Control Group.
In the RIFP group, patients will receive an ultrasound-guided RIFP block at the end of surgery and postoperative analgesia with intravenous morphine PCA. The control group will receive only intravenous morphine PCA without any regional block.
The primary outcome is total morphine consumption during the first 24 postoperative hours.
Secondary outcomes include pain scores at 1, 6, 12, and 24 hours, time to first rescue analgesia, amount of rescue analgesic used, and incidence of postoperative nausea and vomiting.
This study aims to evaluate the postoperative analgesic efficacy and opioid-sparing effect of the RIFP block in living liver donors compared with standard intravenous analgesia.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Rectus Intercostal Plane Block Group | Active Comparator | Rectus Intercostal Plane Block Group The patients in the Rectus Intercostal Plane Block group will receive a bilateral rectus intercostal plane block and patient-controlled analgesia (PCA) with morphine for postoperative analgesia. |
|
| Control Group | Active Comparator | The patients in the Control group will not receive any regional block and will receive PCA with morphine for postoperative analgesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rectus Intercostal Plane Block | Other | Rectus intercostal plane block will be administered bilaterally at the end of the surgery and after skin closure under ultrasound guidance |
|
| Measure | Description | Time Frame |
|---|---|---|
| Morphine consumption | The amount of morphine required by the patient and given by the device will be recorded for the first 24 hours. | Postoperative 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative visual analog scale scores | Postoperative pain will be assessed using a visual analog scale (VAS) (from 0 = no pain to 10 = maximum possible pain) for the first 24 hours. | Postoperative 24 hours |
| Rescue analgesic drug consumption |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| istinye University | Istanbul | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| Control (No Block) | Other | Ultrasound probe placement on the same region without needle insertion or local anesthetic injection to maintain blinding. |
|
The amount of rescue analgesic in mg required by the patient will be recorded for the first 24 hours.
| postoperative 24 hours |
| Incidence of postoperative nausea and vomiting | Number of patients developing postoperative nausea and vomiting will be recorded for the first 24 hours | postoperative 24 hours |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |