title: The efficacy of continuous subcostal transversus abdominis plane block for analgesia after living liver donation: a retrospective study.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Anesthesiology, National Hospital Organization Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, Osaka, 540-0006, Japan. amaeda@anes.med.osaka-u.ac.jp.|Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan. amaeda@anes.med.osaka-u.ac.jp.
authors.forename: Akihiko
authors.identifier: http://orcid.org/0000-0002-1396-7670
authors.initials: A
authors.lastname: Maeda
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Sho Carl
authors.initials: SC
authors.lastname: Shibata
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Takahiko
authors.initials: T
authors.lastname: Kamibayashi
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Fujino
mesh_terms: D000328:Adult; D000698:Analgesia / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy*; D012189:Retrospective Studies; D014839:Vomiting / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D000077554:Levobupivacaine; D002045:Bupivacaine
keywords: Liver transplantation; Living donor; Local anesthetics; Nerve blocks; Postoperative pain