Abstract
Objective
Transversus abdominis plane (TAP) blocks were reported to reduce postoperative pain and opioid use. Local anesthetics modulate the local and systemic inflammatory reaction. Our aim was to examine the effect of TAP block with bupivacaine on the anti-inflammatory response in living liver donors (LLDs).
Methods
The randomized prospective clinical study was carried out 72 LLDs, aged 18–65 scheduled for right hepatectomy. TAP blocks were performed bilaterally with ultrasound guidance using 1.5 mg/kg of 0.5% bupivacaine for Group 2. Group 1 patients were control group. In both groups, blood samples were obtained preoperatively, 30 minutes and 2, 6, and 24 hours following injection for cytokine measurement. In Group 2, to examine the plasma bupivacaine level, blood samples were obtained preoperatively as well as 30 minutes and 1, 2, 6, 12, and 24 hours following injection. The primary outcome was to assess the effect of TAP block on the inflammatory response with cytokine levels.
Results
No difference was observed between cytokine levels (Tumor necrosis factor-alpha (TNF-α), interleukin-1 (IL-1) and interleukin 6 (IL-6) between Groups Significant positive correlations were observed between the plasma bupivacaine concentration and IL-1 and IL-6 levels at the 2nd, 6th and 24th hours
Conclusions
TAP block had no effect on the plasma cytokine concentration. Significant positive correlations were noted between the plasma bupivacaine concentration and IL-1 and IL-6 levels.