{
  "abstract": "Introduction Intrathecal morphine (ITM) provides effective analgesia for pure laparoscopic donor hepatectomy (PLDH); however, its analgesic effect may be insufficient during the immediate postoperative period. We evaluated whether adding bilateral transversus abdominis plane block (TAPB) to ITM enhances analgesia and recovery in living liver donors undergoing PLDH.Methods This randomized controlled trial was conducted at a single center in Korea between 9 May 2023 and 9 October 2024. 80 living liver donors scheduled for PLDH were prospectively randomized into two groups: a control group receiving ITM alone and a TAPB group receiving bilateral TAPB plus ITM. The primary outcome was the worst pain score recorded at rest in the postanesthesia care unit (PACU).Results The worst pain score at rest during the PACU stay was significantly lower in the TAPB group than in the control group (median difference: 3; 95% CI 2 to 4; p<0.001). Lower pain scores persisted in the TAPB group for up to 4 hour postoperatively and were accompanied by significantly decreased cumulative opioid consumption at 1, 4 and 24 hours postoperatively (p=0.029, p=0.023, and p=0.018, respectively). At 24 hours postoperatively, the TAPB group reported a higher Quality of Recovery-15K score than the control group (p=0.030). Incidence of opioid-related complications was comparable between groups.Conclusions Bilateral TAPB combined with ITM significantly enhanced analgesia and reduced opioid requirements during the immediate postoperative period after PLDH in living liver donors. Additionally, TAPB improved the Quality of Recovery at 24 hours postoperatively.Trial registration Clinical research information service identifier: KCT0008406.",
  "authors": [
    {
      "affiliations": [
        "Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"
      ],
      "name": "RyungA Kang"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"
      ],
      "name": "Yu Jeong Bang"
    },
    {
      "affiliations": [
        "Department of Anesthesiology, Froedtert Hospital, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"
      ],
      "name": "Justin Sangwook Ko"
    },
    {
      "affiliations": [
        "Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"
      ],
      "name": "Jong Man Kim"
    },
    {
      "affiliations": [
        "Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"
      ],
      "name": "Gyu-Seong Choi"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"
      ],
      "name": "Ji Seon Jeong"
    },
    {
      "affiliations": [
        "Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"
      ],
      "name": "Gaab Soo Kim"
    }
  ],
  "title": "Transversus abdominis plane block enhances analgesia and reduces opioid use after laparoscopic donor hepatectomy with intrathecal morphine: a randomized controlled trial",
  "uid": "9c547e09-38c9-57f2-a152-82d952b2e2f5"
}