ĐÁNH GIÁ BAN ĐẦU VỀ HIỆU QUẢ VÀ AN TOÀN CỦA GÂY TÊ MẶT PHẲNG CƠ DỰNG SỐNG TRONG GIẢM ĐAU SAU MỔ Ở BỆNH NHÂN GHÉP GAN TẠI BỆNH VIỆN VINMEC TIMES CITY

Abstract

Effective pain management after liver transplantation is essential but challenging due to altered pharmacokinetics and the presence of coagulopathy. This study aimed to evaluate the efficacy and safety of continuous erector spinae plane (ESP) block for postoperative analgesia in liver transplant recipients. Fourteen patients undergoing liver transplantation received bilateral ESP blocks with ropivacaine administered via continuous infusion through catheters. Pain scores were recorded at rest and during movement from postoperative day (POD) 0 to POD3. Additional parameters included ropivacaine plasma concentrations, block-related technical issues, and patient satisfaction assessed by the QoR15 scale. Median pain scores at rest remained consistently low (0.5–0.8), while pain during movement peaked at POD1 (median 2.0) and stabilized thereafter. In seven cases, adjustments to the analgesic regimen were necessary, involving increased ropivacaine concentration or shortened dosing intervals. Only one patient required rescue morphine due to catheter malfunction. Ropivacaine plasma levels remained below toxicity thresholds in all 13 patients tested (mean 0.012 ± 0.003 mg/L). Patient satisfaction was high, with 50% of patients achieving a perfect QoR15 score and a median score of 150 [IQoR: 136–150]. These findings suggest that continuous ESP block is an effective and safe method for postoperative pain control in liver transplant recipients, offering a valuable alternative to neuraxial or systemic opioid-based techniques.