External Oblique Intercostal Plane Block for Liver Transplantation Recipient

Istinye University

Status: Enrolling

Conditions: Postoperative Pain; Liver Transplantation; Recipients of Liver Transplant

Treatments: Other: Sham Procedure; Other: External Oblique Intercostal Plane Block

Study type: Interventional

Funder types: Other

Identifiers

NCT07233083

anestezi 5

Details and patient eligibility

About

Postoperative pain management is one of the key factors in improving rehabilitation and accelerating recovery. The external oblique intercostal plane block can be used to provide abdominal wall analgesia for effective pain control in abdominal surgery.

The aim of this study is to investigate the postoperative analgesic efficacy of the external oblique intercostal plane block in liver transplant recipients.

The investigators will compare a group receiving the external oblique intercostal plane block with a control group to determine whether this block provides effective postoperative analgesia in liver transplant recipients.

Full description

Patients scheduled for liver transplantation will be separated into 2 groups: External Oblique Intercostal Plane Block Group and Control Group.

Patients in the External Oblique Intercostal Plane Block Group will be performed bilateral External Oblique Intercostal Plane Block at the end of the surgery and after skin closure and will receive patient controlled analgesia with morphine for postoperative analgesia.

Patients in the Control Group will not receive any block procedure and will receive patient controlled analgesia with morphine for postoperative analgesia.

Morphine consumption for first postoperative 48 hours, visual analog scale scores, time to need for first rescue analgesia, amount of rescue analgesic drug, incidence of postoperative nausea and vomiting, and Quality of Recovery-15 scores will be recorded.

Enrollment: 60 estimated patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients aged 18 to 75 years
• Scheduled for elective orthotopic liver transplantation (living or deceased donor)
• J-shaped or Mercedes incision planned
• ASA physical status III-IV
• Normal or acceptable coagulation profile at the time of block application (INR ≤ 1.5, platelet count ≥ 50,000/mm³, fibrinogen ≥ 150 mg/dL)
• Able to provide written informed consent

Exclusion criteria

• Coagulopathy at the time of block application (INR > 1.5, platelet count < 50,000/mm³, or fibrinogen < 150 mg/dL)
• Known allergy or hypersensitivity to local anesthetics (amide group)
• Local infection or skin lesion at the block injection site
• Severe hemodynamic instability requiring high-dose vasopressor support
• Chronic opioid use (≥30 mg oral morphine equivalents per day for ≥30 days before surgery)
• Severe hepatic encephalopathy or cognitive impairment preventing use of PCA or pain scoring
• Emergency or re-transplantation surgery

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 2 patient groups

External oblique intercostal plane block group

Active Comparator group

Description:

The patients in the External Oblique Intercostal Plane Block group will receive bilateral external oblique intercostal plane block and patient controlled analgesia (PCA) with morphine for postoperative analgesia.

Treatment:

Other: External Oblique Intercostal Plane Block

Control Group

Sham Comparator group

Description:

The patients in the Control group will not receive any regional block and will receive patient controlled analgesia (PCA) with morphine for postoperative analgesia.

Treatment:

Other: Sham Procedure