title: Ultrasound-guided transversus abdominis plane block for postoperative analgesia in living liver donors: A prospective, randomized, double-blinded clinical trial.
abstract: BACKGROUND
  Transversus abdominis plane (TAP) block is a peripheral nerve block that reduces postoperative pain, nausea, vomiting and the need for postoperative opioids following various types of abdominal surgery. The primary aim of the present study was to evaluate the effects of TAP block on postoperative analgesia and opioid consumption in living liver donors in whom a right "J" abdominal incision was used.
  
  
  METHODS
  This prospective, double-blinded, randomized controlled study was conducted with 50 living liver donors, aged 18-65years, who were scheduled to undergo right hepatectomy. Patients who received ultrasonography-guided subcostal TAP block were allocated into Group 1, and patients who did not receive TAP block were allocated into Group 2. The TAP blocks were performed bilaterally at the conclusion of surgery using 1.5mg∗kg-1bupivacaine diluted with saline to reach a total volume of 40mL. For each patient, morphine consumption, pain scores at rest and movement, sedation scores, nausea, vomiting and the need for antiemetic medication were assessed at 0, 2, 4, 6, 12 and 24h postoperatively by researchers who were blinded to the study groups.
  
  
  RESULTS
  Morphine consumption was significantly lower in Group 1 than in Group 2 at the 2nd, 6th and 24th hours (P<0.05). The mean total morphine consumption values after 24h were 40mg and 65mg in Groups 1 and 2, respectively. The TAP block significantly reduced postoperative visual analog scale pain scores both at rest and during movement at 0, 2, 4, 6, and 24h postoperatively (P<0.05).
  
  
  CONCLUSIONS
  The TAP block reduced 24-h postoperative morphine consumption and contributed to analgesia in living liver donors who underwent upper abdominal wall incisions.
authors.affiliation: Inonu University, School of Medicine, Department of Anaesthesiology and Reanimation, Malatya, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Kıtlık
authors.affiliation: Inonu University, School of Medicine, Department of Anaesthesiology and Reanimation, Malatya, Turkey. Electronic address: drmalierdogan@gmail.com.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Erdogan
authors.affiliation: Inonu University, School of Medicine, Department of Anaesthesiology and Reanimation, Malatya, Turkey.
authors.forename: Ulku
authors.initials: U
authors.lastname: Ozgul
authors.affiliation: Inonu University, School of Medicine, Department of Anaesthesiology and Reanimation, Malatya, Turkey.
authors.forename: Mustafa Said
authors.initials: MS
authors.lastname: Aydogan
authors.affiliation: Inonu University, School of Medicine, Department of Anaesthesiology and Reanimation, Malatya, Turkey.
authors.forename: Muharrem
authors.initials: M
authors.lastname: Ucar
authors.affiliation: Inonu University, School of Medicine, Department of Anaesthesiology and Reanimation, Malatya, Turkey.
authors.forename: Huseyin Ilksen
authors.initials: HI
authors.lastname: Toprak
authors.affiliation: Inonu University, School of Medicine, Department of Biostatistics and Medical Informatics, Malatya, Turkey.
authors.forename: Cemil
authors.initials: C
authors.lastname: Colak
authors.affiliation: Inonu University, School of Medicine, Department of Anaesthesiology and Reanimation, Malatya, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Durmus
mesh_terms: D000009:Abdominal Muscles; D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D000932:Antiemetics / Q000008:administration & dosage / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use; D004311:Double-Blind Method; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D019520:Living Donors; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000517:prevention & control; D011446:Prospective Studies; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D018084:Ultrasonography, Interventional; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000932:Antiemetics; D009020:Morphine; D002045:Bupivacaine
keywords: Living liver donor; Postoperative pain; Transversus abdominis plane block