Transversus Abdominus Plane Block in Living Donor Hepatectomy

Study Overview
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Brief Summary
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Comparing different drugs used in Transversus abdominus plane analgesia after donor hepatectomy. Patients will be divided into three groups; control group, Bupivecaine group, and Dexmedetomedine group according to the used drug

Detailed Description
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Transversus abdominus plane block for postoperative analgesia after donor hpatectomy surgery using three different drugs control group, Bupivecaine group, and Dexmedetomedine group

Conditions
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Living Donor Hepatectomy

Intervention / Treatment
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* Device: surgically inserted Transversus abdominus plane catheter
* Drug: Intravenous morphine
* Drug: Bupevecaine
* Drug: Dexmedetomedine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all living hepatectomy donors in Mansoura liver transplantation program Exclusion Criteria: refusal known sensetivity to used drugs

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control<br>Control group where postoperative analgesia will be maintained by Morphine intravenous boluses (2 mg) if Visual analogue scale (VAS) scale more than 4. | Drug: Intravenous morphine<br>* Boluses of intravenous morphine (2 mg) will be given to patients if Visual analogue scale (VAS) more than 3<br>|
| Active Comparator: Bupevecaine group<br>Postoperative analgesia will be maintained by 20 ml Bupevecaine (0.25%) boluses in surgically inserted TAP catheter each 8 hours for 48 hours with rescue analgesia intravenous morphine (2mg) if VAS more than 4 | Device: surgically inserted Transversus abdominus plane catheter<br>* at end of surgery, a surgeon will insert catheter in Transversus abdominus plane (TAP) between internal oblique muscle and Transversus abdominus muscle<br>Drug: Intravenous morphine<br>* Boluses of intravenous morphine (2 mg) will be given to patients if Visual analogue scale (VAS) more than 3<br>Drug: Bupevecaine<br> <br> |
| Active Comparator: Dex group<br>catheter will surgically inserted in Transversus abdominus plane (TAP) plane before wound closure Postoperative analgesia will be maintained by Dexmedetomedine 0.4 mg/kg plus Bupevecaine 0.25 20 ml boluses each 8 hours for 48 hours in surgically inserted TAP catheter with rescue analgesia intravenous morphine (2mg) if VAS more 4 | Device: surgically inserted Transversus abdominus plane catheter<br>* at end of surgery, a surgeon will insert catheter in Transversus abdominus plane (TAP) between internal oblique muscle and Transversus abdominus muscle<br>Drug: Intravenous morphine<br>* Boluses of intravenous morphine (2 mg) will be given to patients if Visual analogue scale (VAS) more than 3<br>Drug: Bupevecaine<br> <br> Drug: Dexmedetomedine<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative morphine (mg) consumption in 1st 48 hours |  | 48 hours postoperative |