The Analgesic Efficacy of Ultrasound-Guided Transversus Abdominis Plane Block for Laparoscopic Living Donor Hepatectomy: A Randomized Controlled Study

Purpose: The transversus abdominis plane (TAP) block provides effective postoperative analgesia for abdominal surgeries. However, its efficacy in laparoscopic living donor hepatectomy (LLDH) remains uncertain. This study aimed to assess the impact of ultrasound-guided TAP block on postoperative analgesia and recovery quality in living liver donors undergoing LLDH. Patients and Methods: In this prospective, randomized, double-blind controlled trial, eighty patients scheduled for LLDH were randomly allocated 1:1 to receive ultrasound-guided bilateral single-injection TAP block (Group T) or local incisional infiltration (Group C). The primary outcome was total opioid consumption within 24 hours postoperatively. Secondary outcomes were visual analogue scale (VAS) pain scores, opioid consumption within 48h postoperatively, Quality of Recovery-15 (QoR-15) scores, time to first flatus and ambulation, length of hospital stay (LOS), postoperative liver function, opioid related adverse reactions, and puncture-related complications. Results: The total opioid consumption within 24 hours postoperatively as the primary outcome was significantly lower in group T compared to group C (42 38.5, 54 mg vs. 62 52, 68 mg, P < 0.001), and this significant difference was also present at 48 hours postoperatively (98 84.5, 104.5 mg vs. 112 102, 133 mg, P < 0.001). The VAS scores at rest and movement were also lower in Group T at 2h after surgery ( P < 0.01). Moreover, patients in Group T had earlier first postoperative flatus ( P = 0.012). No significant differences between groups were observed in other secondary outcomes. Conclusion: Ultrasound-guided TAP block can reduce postoperative opioid consumption, alleviate early postoperative pain without increasing adverse events in living donors undergoing the LLDH. Keywords: TAP block, living donor, laparoscopic living donor hepatectomy, postoperative analgesia