Techniques for Perioperative Analgesia for Live Liver Donors; A Pilot Study

Ain Shams University20 enrolled

Overview

This study,will evaluate the efficacy of ultrasound (US)-guided subcostal oblique TAP block together with IV infusion of Dexmedetomidine and fentanyl as a type of multimodal analgesic regimen in comparison with IV fentanyl based analgesia only in live liver donors.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Anesthesia

Interventions

Fentanyl infusionDRUG

After induction of general anesthesia; Fentanyl infusion (0.5 µg/kg/hr) will be started (which will be afterwards adjusted intraoperatively according to the hemodynamics and Bispectral Index (BIS) reading).

Ultrasound guided TAP blockPROCEDURE

After induction of general anesthesia; Patients will receive ultrasound guided subcostal oblique TAP block with 0.25 % bupivacaine 40 ml on each side resulting in a total volume of 80 ml, subcostal TAP block was given twice, at the beginning and at the end of the surgery.

DexmedetomidineDRUG

Dexmedetomidine (200 µg in 2 ml diluted in 48 ml of saline) will be started in a dose of 1 μg/kg over 10 min then maintenance dose as continuous infusion between 0.2 and 0.8 μg/ kg/h through infusion pump (which will be adjusted according to the hemodynamics and BIS reading)

Eligibility

Sex: ALLMin age: 20 YearsMax age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesia (ASA) physical status I or II * Scheduled as live liver donors * J-shaped incision in the supraumblical region Exclusion Criteria: * Patients with a history of psychiatric/neurological illness, * Hypertensive patients, * Morbidly obese patients, * Pregnant and nursing women, * Patients with known allergic reaction to any of the study medications, * Patients on recent use of sedatives or analgesics, * Patients with significant laboratory abnormalities

Locations (1)

Hospitals of Faculty of Medicine , Ain Shams University

Cairo, Egypt

Outcomes

Primary Outcomes

Total fentanyl consumption

Total Intravenous fentanyl consumption during the operation

Time frame: Intraoperative

Secondary Outcomes

Average sevoflurane concentration

The average sevoflurane concentration (the average concentration (%) for the case will be determined from the vaporizer setting recorded in the anesthetic record per 5-minute interval)

Time frame: Intraoperative

The severity of postoperative nausea and vomiting (PONV)

Will be recorded and classified as "no PONV, mild PONV, moderate PONV and severe PONV"

Time frame: First 24 hours postoperatively

Ramsay sedation score (RSS)

Will be used for assessment of sedation immediately after extubation, after 2 hours of ICU admission, after 12 hours then after 24 hours .

Time frame: First 24 hours postoperatively

Data from ClinicalTrials.gov

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