Prospective, randomized study of ropivacaine wound infusion versus intrathecal morphine with intravenous fentanyl for analgesia in living donors for liver transplantation.
Lee SH, Gwak MS, et al.Liver Transplantation 19(9): 1036-1045.
Aims
To compare the efficacy and safety of two analgesic regimes: a continuous wound infusion of 0.5% ropivacaine and single dose intrathecal morphine (ITM) with IV fentanyl in living donors for liver transplantation.
Interventions
Participants were administered with a single preoperative dose of ITM (400ug) and continuous postoperative infusion of IV fentanyl, or ropivacaine at the end of surgery.
Participants
40 adult living donors for liver transplantation.
Outcomes
The primary outcome was the VAS score at rest and with coughing. The secondary outcome included opioid consumption.
Follow-up
72 hours.
CET Conclusions
PainBuster continuous local anaesthetic with ropivacaine was compared to intrathecal+intravenous fentanyl in the setting of live donor hemi-hepatectomy. Soaker catheters in the PainBuster group were inserted by Seldinger technique between the internal oblique and the transversus abdominis. Rescue analgesia with IV fentanyl was available to both groups. The PainBuster group had a longer surgical time (403 versus 369 minutes mean) and worse visual analogue pain scores during the first 12 hours post-operatively. More rescue analgesia was also required by the PainBuster group during the first 24 hours.
Data analysis
Available case analysis
Trial registration
Australian New Zealand Clinical Trials Registry - ACTRN12612000530820