{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T02:39:18Z","timestamp":1780627158318,"version":"3.54.1"},"reference-count":28,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2025,9,10]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Intrathecal morphine (ITM) provides effective analgesia for pure laparoscopic donor hepatectomy (PLDH); however, its analgesic effect may be insufficient during the immediate postoperative period. We evaluated whether adding bilateral transversus abdominis plane block (TAPB) to ITM enhances analgesia and recovery in living liver donors undergoing PLDH.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This randomized controlled trial was conducted at a single center in Korea between 9 May 2023 and 9 October 2024. 80 living liver donors scheduled for PLDH were prospectively randomized into two groups: a control group receiving ITM alone and a TAPB group receiving bilateral TAPB plus ITM. The primary outcome was the worst pain score recorded at rest in the postanesthesia care unit (PACU).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The worst pain score at rest during the PACU stay was significantly lower in the TAPB group than in the control group (median difference: 3; 95% CI 2 to 4; p&lt;0.001). Lower pain scores persisted in the TAPB group for up to 4\u2009hour postoperatively and were accompanied by significantly decreased cumulative opioid consumption at 1, 4 and 24\u2009hours postoperatively (p=0.029, p=0.023, and p=0.018, respectively). At 24\u2009hours postoperatively, the TAPB group reported a higher Quality of Recovery-15K score than the control group (p=0.030). Incidence of opioid-related complications was comparable between groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Bilateral TAPB combined with ITM significantly enhanced analgesia and reduced opioid requirements during the immediate postoperative period after PLDH in living liver donors. Additionally, TAPB improved the Quality of Recovery at 24\u2009hours postoperatively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration<\/jats:title>\n                  <jats:p>Clinical research information service identifier: KCT0008406.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2025-106943","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T07:55:25Z","timestamp":1758873325000},"page":"rapm-2025-106943","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Transversus abdominis plane block enhances analgesia and reduces opioid use after laparoscopic donor hepatectomy with intrathecal morphine: a randomized controlled trial"],"prefix":"10.1136","author":[{"given":"RyungA","family":"Kang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu Jeong","family":"Bang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3155-0550","authenticated-orcid":false,"given":"Justin Sangwook","family":"Ko","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Froedtert Hospital, Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Man","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyu-Seong","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Seon","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaab Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"2025092600551611000_rapm-2025-106943v1.1","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1007\/s00423-023-03144-4","article-title":"Global liver transplantation: emerging trends and ethical challenges","volume":"408","author":"Hill","year":"2023","journal-title":"Langenbecks Arch Surg"},{"key":"2025092600551611000_rapm-2025-106943v1.2","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1002\/lt.25307","article-title":"Laparoscopic Donor Hepatectomy for Adult Living Donor Liver Transplantation Recipients","volume":"24","author":"Kwon","year":"2018","journal-title":"Liver Transpl"},{"key":"2025092600551611000_rapm-2025-106943v1.3","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2019-100902"},{"key":"2025092600551611000_rapm-2025-106943v1.4","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2022-103577"},{"key":"2025092600551611000_rapm-2025-106943v1.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-003-9070-4"},{"key":"2025092600551611000_rapm-2025-106943v1.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2008.09.015"},{"key":"2025092600551611000_rapm-2025-106943v1.7","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.mayocpiqo.2018.03.003","article-title":"Acute Benefits After Liposomal Bupivacaine Abdominal Wall Blockade for Living Liver Donation: A Retrospective Review","volume":"2","author":"Amundson","year":"2018","journal-title":"Mayo Clin Proc Innov Qual Outcomes"},{"key":"2025092600551611000_rapm-2025-106943v1.8","doi-asserted-by":"crossref","first-page":"2889","DOI":"10.2147\/DDDT.S255385","article-title":"The Safety and Efficacy of Ultrasound-Guided Bilateral Dual Transversus Abdominis Plane (BD-TAP) Block in ERAS Program of Laparoscopic Hepatectomy: A Prospective, Randomized, Controlled, Blinded, Clinical Study","volume":"14","author":"Zhang","year":"2020","journal-title":"Drug Des Devel Ther"},{"key":"2025092600551611000_rapm-2025-106943v1.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.05.029"},{"key":"2025092600551611000_rapm-2025-106943v1.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-017-2323-5"},{"key":"2025092600551611000_rapm-2025-106943v1.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2010.05.008"},{"key":"2025092600551611000_rapm-2025-106943v1.12","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s00268-022-06732-5","article-title":"Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022","volume":"47","author":"Joliat","year":"2023","journal-title":"World J Surg"},{"key":"2025092600551611000_rapm-2025-106943v1.13","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1007\/s00268-022-06518-9","article-title":"Healthy Spouses can be Considered as Living Liver Donors","volume":"46","author":"Lee","year":"2022","journal-title":"World J Surg"},{"key":"2025092600551611000_rapm-2025-106943v1.14","doi-asserted-by":"crossref","DOI":"10.1111\/ctr.14996","article-title":"Comparison of two doses of intrathecal morphine in laparoscopic donor hepatectomy: A randomized double-blinded non-inferiority trial","volume":"37","author":"Lee","year":"2023","journal-title":"Clin Transplant"},{"key":"2025092600551611000_rapm-2025-106943v1.15","doi-asserted-by":"crossref","DOI":"10.1155\/2017\/8284363","article-title":"Transversus Abdominis Plane Block: An Updated Review of Anatomy and Techniques","volume":"2017","author":"Tsai","year":"2017","journal-title":"Biomed Res Int"},{"key":"2025092600551611000_rapm-2025-106943v1.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2009.06.004"},{"key":"2025092600551611000_rapm-2025-106943v1.17","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/j.bja.2020.06.040","article-title":"Validation and clinical utility of the Korean version of the Quality of Recovery-15 with enhanced recovery after surgery: a prospective observational cohort study","volume":"125","author":"Yoon","year":"2020","journal-title":"Br J Anaesth"},{"key":"2025092600551611000_rapm-2025-106943v1.18","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.pmn.2006.09.001","article-title":"Determination of clinically meaningful levels of pain reduction in patients experiencing acute postoperative pain","volume":"7","author":"Sloman","year":"2006","journal-title":"Pain Manag Nurs"},{"key":"2025092600551611000_rapm-2025-106943v1.19","doi-asserted-by":"crossref","first-page":"5787","DOI":"10.62347\/LCKG5157","article-title":"Meta-analysis of risk factors associated with postoperative hypoxemia in the postanesthesia care unit","volume":"16","author":"Xiong","year":"2024","journal-title":"Am J Transl Res"},{"key":"2025092600551611000_rapm-2025-106943v1.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2005.07.015"},{"key":"2025092600551611000_rapm-2025-106943v1.21","doi-asserted-by":"crossref","first-page":"3343","DOI":"10.2147\/JPR.S426570","article-title":"Correlation Between Pain Intensity and Quality of Recovery After Video-Assisted Thoracic Surgery for Lung Cancer Resection","volume":"16","author":"Yoon","year":"2023","journal-title":"J Pain Res"},{"key":"2025092600551611000_rapm-2025-106943v1.22","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aen344"},{"key":"2025092600551611000_rapm-2025-106943v1.23","doi-asserted-by":"crossref","first-page":"81","DOI":"10.2147\/LRA.S138537","article-title":"Anesthetic techniques: focus on transversus abdominis plane (TAP) blocks","volume":"12","author":"Mallan","year":"2019","journal-title":"Local Reg Anesth"},{"key":"2025092600551611000_rapm-2025-106943v1.24","doi-asserted-by":"crossref","first-page":"235","DOI":"10.4174\/astr.2021.100.4.235","article-title":"Postoperative outcomes of purely laparoscopic donor hepatectomy compared to open living donor hepatectomy: a preliminary observational study","volume":"100","author":"Bang","year":"2021","journal-title":"Ann Surg Treat Res"},{"key":"2025092600551611000_rapm-2025-106943v1.25","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aep243"},{"key":"2025092600551611000_rapm-2025-106943v1.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2019.04.012"},{"key":"2025092600551611000_rapm-2025-106943v1.27","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes279"},{"key":"2025092600551611000_rapm-2025-106943v1.28","doi-asserted-by":"crossref","first-page":"221","DOI":"10.4174\/astr.2021.101.4.221","article-title":"The additional analgesic effects of transverse abdominis plane block in patients receiving low-dose intrathecal morphine for minimally invasive colorectal surgery: a randomized, single-blinded study","volume":"101","author":"Han","year":"2021","journal-title":"Ann Surg Treat Res"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2025-106943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T07:55:30Z","timestamp":1758873330000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2025-106943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,25]]},"references-count":28,"alternative-id":["10.1136\/rapm-2025-106943"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2025-106943","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,25]]}}}