Living liver donor pain management

Ryung A. Kang,Justin Sangwook Ko

CURRENT OPINION IN ORGAN TRANSPLANTATION(2023)

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摘要
Purpose of reviewOptimal pain control in living liver donors undergoing hepatectomy is strongly recommended considering their unique status as healthy individuals willingly undergoing surgery for the benefit of the recipient. This review aims to examine and evaluate different strategies aimed at ensuring effective postoperative pain management in living liver donors.Recent findingsEnhanced recovery after surgery (ERAS) protocols have proven effective in optimizing patient outcomes, including in living liver donor hepatectomy. By implementing these protocols, healthcare professionals can enhance postoperative pain control and accelerate recovery. Multimodal analgesia, which combines different techniques and agents, is crucial in pain management for living liver donors. Regional analgesia techniques, such as spinal anesthesia and various peripheral nerve blocks, have shown efficacy in reducing pain and facilitating early recovery. Systemic nonopioid analgesics, including acetaminophen, nonsteroidal anti-inflammatory drugs, ketamine, lidocaine, and dexmedetomidine act synergistically to alleviate pain and reduce inflammation. Minimizing the use of opioids is important to avoid adverse effects, and they should be reserved for rescue medication or breakthrough pain.SummaryApplying the principles of ERAS and multimodal analgesia to living liver donors can effectively control pain while promoting early recovery.
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关键词
enhanced recovery after surgery,liver transplantation,living donor hepatectomy,multimodal analgesia
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