The Role of the Subcostal Transversus Abdominis Plane Block in Facilitating Operating Room Extubation After Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Propensity Score-Matching Analysis
<b>Background:</b> Effective pain management is essential to early extubation and recovery in living donor liver transplantation (LDLT). The subcostal transversus abdominis plane (TAP) block has emerged as a potential strategy to address postoperative pain while reducing opioid consumpti...
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MDPI AG
2025-02-01
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| author | Jaewon Huh Min Suk Chae |
| author_facet | Jaewon Huh Min Suk Chae |
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| description | <b>Background:</b> Effective pain management is essential to early extubation and recovery in living donor liver transplantation (LDLT). The subcostal transversus abdominis plane (TAP) block has emerged as a potential strategy to address postoperative pain while reducing opioid consumption. This study evaluated the effectiveness of the TAP block in facilitating early extubation in the OR and examined its impact on re-intubation rates, postoperative fentanyl requirements, and pain intensity upon ICU admission to determine its role in perioperative pain management. <b>Methods:</b> This retrospective cohort study included adult patients who underwent LDLT for hepatocellular carcinoma within the Milan criteria. Propensity score matching was performed to compare outcomes between patients who received the subcostal TAP block and those who did not. The primary outcome was the rate of successful extubation in the operating room (OR). Secondary outcomes included re-intubation rates, postoperative fentanyl requirements, and peak numeric rating scale (NRS) pain scores upon ICU admission. <b>Results:</b> The subcostal TAP block was associated with a significantly higher rate of successful OR extubation compared with no TAP block. Multivariable analysis revealed that the TAP block independently increased the likelihood of successful extubation. Patients receiving the TAP block required less fentanyl for pain management and demonstrated lower peak NRS pain scores upon ICU admission. No complications related to the TAP block were observed, underscoring its safety in this high-risk population. <b>Conclusions:</b> The subcostal TAP block facilitates early OR extubation by effectively managing postoperative pain and reducing opioid requirements, promoting smoother recovery without increasing adverse events. These findings support its inclusion in multimodal analgesia protocols for optimizing perioperative outcomes in LDLT patients. |
| format | Article |
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| institution | DOAJ |
| issn | 2075-1729 |
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| spelling | doaj-art-2a08689a0c5b4cbb9c4f977d2f9b829d2025-08-20T03:12:00ZengMDPI AGLife2075-17292025-02-0115229710.3390/life15020297The Role of the Subcostal Transversus Abdominis Plane Block in Facilitating Operating Room Extubation After Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Propensity Score-Matching AnalysisJaewon Huh0Min Suk Chae1Department of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea<b>Background:</b> Effective pain management is essential to early extubation and recovery in living donor liver transplantation (LDLT). The subcostal transversus abdominis plane (TAP) block has emerged as a potential strategy to address postoperative pain while reducing opioid consumption. This study evaluated the effectiveness of the TAP block in facilitating early extubation in the OR and examined its impact on re-intubation rates, postoperative fentanyl requirements, and pain intensity upon ICU admission to determine its role in perioperative pain management. <b>Methods:</b> This retrospective cohort study included adult patients who underwent LDLT for hepatocellular carcinoma within the Milan criteria. Propensity score matching was performed to compare outcomes between patients who received the subcostal TAP block and those who did not. The primary outcome was the rate of successful extubation in the operating room (OR). Secondary outcomes included re-intubation rates, postoperative fentanyl requirements, and peak numeric rating scale (NRS) pain scores upon ICU admission. <b>Results:</b> The subcostal TAP block was associated with a significantly higher rate of successful OR extubation compared with no TAP block. Multivariable analysis revealed that the TAP block independently increased the likelihood of successful extubation. Patients receiving the TAP block required less fentanyl for pain management and demonstrated lower peak NRS pain scores upon ICU admission. No complications related to the TAP block were observed, underscoring its safety in this high-risk population. <b>Conclusions:</b> The subcostal TAP block facilitates early OR extubation by effectively managing postoperative pain and reducing opioid requirements, promoting smoother recovery without increasing adverse events. These findings support its inclusion in multimodal analgesia protocols for optimizing perioperative outcomes in LDLT patients.https://www.mdpi.com/2075-1729/15/2/297subcostal TAP blockliving donor liver transplantationearly extubationoperating room |
| spellingShingle | Jaewon Huh Min Suk Chae The Role of the Subcostal Transversus Abdominis Plane Block in Facilitating Operating Room Extubation After Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Propensity Score-Matching Analysis Life subcostal TAP block living donor liver transplantation early extubation operating room |
| title | The Role of the Subcostal Transversus Abdominis Plane Block in Facilitating Operating Room Extubation After Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Propensity Score-Matching Analysis |
| title_full | The Role of the Subcostal Transversus Abdominis Plane Block in Facilitating Operating Room Extubation After Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Propensity Score-Matching Analysis |
| title_fullStr | The Role of the Subcostal Transversus Abdominis Plane Block in Facilitating Operating Room Extubation After Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Propensity Score-Matching Analysis |
| title_full_unstemmed | The Role of the Subcostal Transversus Abdominis Plane Block in Facilitating Operating Room Extubation After Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Propensity Score-Matching Analysis |
| title_short | The Role of the Subcostal Transversus Abdominis Plane Block in Facilitating Operating Room Extubation After Living Donor Liver Transplantation for Hepatocellular Carcinoma: A Propensity Score-Matching Analysis |
| title_sort | role of the subcostal transversus abdominis plane block in facilitating operating room extubation after living donor liver transplantation for hepatocellular carcinoma a propensity score matching analysis |
| topic | subcostal TAP block living donor liver transplantation early extubation operating room |
| url | https://www.mdpi.com/2075-1729/15/2/297 |
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