Anesthesia
Conditions
Keywords
Transversus abdominis plane block,, Dexmedetomidine, Fentanyl, Live liver donor, Liver transplantation
Brief summary
This study,will evaluate the efficacy of ultrasound (US)-guided subcostal oblique TAP block together with IV infusion of Dexmedetomidine and fentanyl as a type of multimodal analgesic regimen in comparison with IV fentanyl based analgesia only in live liver donors.
Interventions
After induction of general anesthesia; Fentanyl infusion (0.5 µg/kg/hr) will be started (which will be afterwards adjusted intraoperatively according to the hemodynamics and Bispectral Index (BIS) reading).
PROCEDUREUltrasound guided TAP block
After induction of general anesthesia; Patients will receive ultrasound guided subcostal oblique TAP block with 0.25 % bupivacaine 40 ml on each side resulting in a total volume of 80 ml, subcostal TAP block was given twice, at the beginning and at the end of the surgery.
DRUGDexmedetomidine
Dexmedetomidine (200 µg in 2 ml diluted in 48 ml of saline) will be started in a dose of 1 μg/kg over 10 min then maintenance dose as continuous infusion between 0.2 and 0.8 μg/ kg/h through infusion pump (which will be adjusted according to the hemodynamics and BIS reading)
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
20 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesia (ASA) physical status I or II * Scheduled as live liver donors * J-shaped incision in the supraumblical region
Exclusion criteria
* Patients with a history of psychiatric/neurological illness, * Hypertensive patients, * Morbidly obese patients, * Pregnant and nursing women, * Patients with known allergic reaction to any of the study medications, * Patients on recent use of sedatives or analgesics, * Patients with significant laboratory abnormalities
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total fentanyl consumption | Intraoperative | Total Intravenous fentanyl consumption during the operation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Average sevoflurane concentration | Intraoperative | The average sevoflurane concentration (the average concentration (%) for the case will be determined from the vaporizer setting recorded in the anesthetic record per 5-minute interval) |
| The severity of postoperative nausea and vomiting (PONV) | First 24 hours postoperatively | Will be recorded and classified as no PONV, mild PONV, moderate PONV and severe PONV |
| Ramsay sedation score (RSS) | First 24 hours postoperatively | Will be used for assessment of sedation immediately after extubation, after 2 hours of ICU admission, after 12 hours then after 24 hours . |
Countries
Egypt
Outcome results
None listed