Liver Transplantation, Living Donor, Postoperative Pain
Conditions
Brief summary
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.
Detailed description
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.
Interventions
OTHERRectus Intercostal Plane Block
Rectus intercostal plane block will be administered bilaterally at the end of the surgery and after skin closure under ultrasound guidance
OTHERControl (No Block)
Ultrasound probe placement on the same region without needle insertion or local anesthetic injection to maintain blinding.
Sponsors
Istinye University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 75 years * Patients with American Society of Anesthesiology (ASA) physical status I-II * Patients scheduled for a living donor hepatectomy
Exclusion criteria
* Allergy to local anesthetics * Coagulopathy * Skin infection at the block area * Advanced renal failure * Chronic pain syndromes * Alcohol or drug abuse * Psychiatric disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Morphine consumption | Postoperative 24 hours | The amount of morphine required by the patient and given by the device will be recorded for the first 24 hours. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative visual analog scale scores | Postoperative 24 hours | 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. |
| Rescue analgesic drug consumption | postoperative 24 hours | The amount of rescue analgesic in mg required by the patient will be recorded for the first 24 hours. |
| Incidence of postoperative nausea and vomiting | postoperative 24 hours | Number of patients developing postoperative nausea and vomiting will be recorded for the first 24 hours |
Countries
Turkey (Türkiye)
Outcome results
None listed