The efficacy of continuous subcostal transversus abdominis plane block for analgesia after living liver donation: a retrospective study.
PURPOSE
Postoperative pain management for living liver donors has become a major concern as a result of the increasing number of living liver donations. Transversus abdominis plane (TAP) block has been known to provide effective analgesia for abdominal surgery. The aim of this study was to evaluate the efficacy of ultrasound-guided continuous subcostal TAP block as a part of a multimodal analgesic regimen in comparison with conventional intravenous (IV) fentanyl-based analgesia in living liver donors.


METHODS
Thirty-two donors were retrospectively classified into either the continuous subcostal TAP block group (TAP group) or the IV fentanyl-based analgesia group (control group). TAP group donors received bilateral continuous subcostal TAP infusion of 0.125 % levobupivacaine at 6 ml/h. Control group donors did not receive any neural blockade.


RESULTS
Cumulative fentanyl consumption was significantly lower in the TAP group for 48 h (P < 0.01) as compared to the control group. Further, the donors in the TAP group had significantly lower incidence of nausea and vomiting during 24-48 h postoperatively (P < 0.01) and fewer delays in the initiation of oral intake than those in the control group (P = 0.02).


CONCLUSIONS
In conclusion, continuous subcostal TAP block provided an effective opioid-sparing analgesia for living liver donors.
['Maeda|Akihiko|A|http://orcid.org/0000-0002-1396-7670', 'Shibata|Sho Carl|SC|', 'Wada|Hiroshi|H|', 'Marubashi|Shigeru|S|', 'Kamibayashi|Takahiko|T|', 'Eguchi|Hidetoshi|H|', 'Fujino|Yuji|Y|']
D000328:Adult D000698:Analgesia D000701:Analgesics, Opioid D002045:Bupivacaine D005260:Female D006801:Humans D000077554:Levobupivacaine D016031:Liver Transplantation D019520:Living Donors D008297:Male D008875:Middle Aged D009325:Nausea D009407:Nerve Block D010149:Pain, Postoperative D012189:Retrospective Studies D014839:Vomiting
Postoperative pain Liver transplantation Living donor Local anesthetics Nerve blocks