Comparison of the Postoperative Analgesic Effects of ITM and Bi-level ESPB in Liver Transplantation Donors

Ankara Etlik City Hospital

Status: Enrolling

Conditions: Liver Transplantation; Pain Management

Treatments: Procedure: Bi-level Erector Spinae Plane Block; Procedure: Intrathecal Morphine

Study type: Interventional

Funder types: Other

Identifiers

NCT07123740

AEŞH-EK-2025-155

Details and patient eligibility

About

Liver transplantation is a life-saving procedure for patients with end-stage liver disease, and postoperative pain management is critical for optimizing donor recovery and overall outcomes. Poorly controlled pain following donor hepatectomy may reduce quality of life, delay mobilization, and contribute to the development of chronic pain syndromes.

Regional anesthesia techniques, such as intrathecal morphine and erector spinae plane block, have been utilized to enhance postoperative analgesia and reduce perioperative opioid requirements, potentially minimizing opioid-related adverse effects.

In this study, we aimed to compare the postoperative analgesic efficacy of intrathecal morphine and Bi-level erector spinae plane block in living liver donors.

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients aged 18-65 years
• American Society of Anesthesiologists (ASA) score I-II
• Body Mass Index (BMI) between 18-30 kg/m2

Exclusion criteria

• Patients under 18 and over 65 years of age
• ASA score III and above
• Patients with a history of bleeding diathesis
• BMI below 18 or above 30 kg/m2

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 2 patient groups

Intrathecal Morphine

Active Comparator group

Description:

An intrathecal injection of morphine 300μg will be administered at the L3-L4 or L4-L5 level. In the intraoperative period, intravenous meperidine 0.5 mg/kg will be given 30min before the end of surgery.

Treatment:

Procedure: Intrathecal Morphine

Bi-level Erector Spinae Plane Block

Active Comparator group

Description:

After the linear ultrasound (US) probe will be placed 2-3 cm lateral to the T8 spinous process, 10 ml of 0.25% bupivacaine hydrochloride will be injected cauda-cranially into the interfacial space below the erector spinae muscle, above the transverse process. Next, the needle will be withdrawn till subcutaneously and the linear US probe will be placed 2-3 cm lateral to the T10 spinous process. Finally, 10 ml of 0.25% bupivacaine hydrochloride will be injected cranio-caudally into the interfacial space below the erector spinae muscle, above the transverse process. This procedure will be performed bilaterally. A total of 40 ml of 0.25% bupivacaine will be injected for bilateral and bi-level ESPB application. In the intraoperative period, intravenous meperidine 0.5 mg/kg will be given 30min before the end of surgery.

Treatment:

Procedure: Bi-level Erector Spinae Plane Block