title: Effect of transversus abdominis plane block in combination with general anesthesia on perioperative opioid consumption, hemodynamics, and recovery in living liver donors: The prospective, double-blinded, randomized study.
abstract: Transversus abdominis plane (TAP) block provides effective postoperative analgesia after abdominal surgeries. It can be also a useful strategy to reduce perioperative opioid consumption, support intraoperative hemodynamic stability, and promote early recovery from anesthesia. The aim of this prospective randomized double-blind study was to assess the effect of subcostal TAP blocks on perioperative opioid consumption, hemodynamic, and recovery time in living liver donors.
  
  
  
  The prospective, double-blinded, randomized controlled study was conducted with 49 living liver donors, aged 18-65 years, who were scheduled to undergo right hepatectomy. Patients who received subcostal TAP block in combination with general anesthesia were allocated into Group 1, and patients who received general anesthesia alone were allocated into Group 2. The TAP blocks were performed bilaterally by obtaining an image with real-time ultrasound guidance using 0.5% bupivacaine diluted with saline to reach a total volume of 40 mL. The primary outcome measure in our study was perioperative remifentanil consumption. Secondary outcomes were mean blood pressure (MBP), heart rate (HR), mean desflurane requirement, anesthesia recovery time, frequency of emergency vasopressor use, total morphine use, and length of hospital stay.
  
  
  
  Total remifentanil consumption and the anesthesia recovery time were significantly lower in Group 1 compared with Group 2. Postoperative total morphine use and length of hospital stay were also reduced. Changes in the MAP and HR were similar in the both groups. There were no significant differences in HR and MBP between groups at any time.
  
  
  
  Combining subcostal TAP blocks with general anesthesia significantly reduced perioperative and postoperative opioid consumption, provided shorter anesthesia recovery time, and length of hospital stay in living liver donors.
authors.affiliation: Department of Anaesthesiology and Reanimation, School of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Mehmet A
authors.identifier: 0000-0002-3860-6919
authors.initials: MA
authors.lastname: Erdogan
authors.affiliation: Department of Anaesthesiology and Reanimation, School of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Ulku
authors.initials: U
authors.lastname: Ozgul
authors.affiliation: Department of Anaesthesiology and Reanimation, School of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Muharrem
authors.initials: M
authors.lastname: Uçar
authors.affiliation: Department of Anaesthesiology and Reanimation, School of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Mehmet R
authors.initials: MR
authors.lastname: Yalin
authors.affiliation: Department of Anaesthesiology and Reanimation, School of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Yusuf Z
authors.initials: YZ
authors.lastname: Colak
authors.affiliation: Department of Biostatistics and Medical Informatics, School of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Cemil
authors.initials: C
authors.lastname: Çolak
authors.affiliation: Department of Anaesthesiology and Reanimation, School of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Huseyin I
authors.initials: HI
authors.lastname: Toprak
mesh_terms: D000009:Abdominal Muscles; D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000768:Anesthesia, General / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid
keywords: anesthesia; living liver donor; recovery; remifentanil; transversus abdominis plane block