CẬP NHẬT BẰNG CHỨNG VỀ GIẢM ĐAU ĐA MÔ THỨC SAU PHẪU THUẬT GAN: CƠ SỞ LỰA CHỌN THUỐC GIẢM ĐAU TOÀN THÂN VÀ GÂY TÊ VÙNG

Abstract

Liver surgery is a major abdominal procedure frequently associated with significant postoperative pain. Inadequate pain control can impair recovery, prolong hospital stay, and reduce the quality of perioperative care. This review aims to provide an updated synthesis of evidence on multimodal analgesia approaches for liver surgery, with a focus on regional anesthesia techniques. Multimodal analgesia strategies combining systemic agents such as paracetamol and NSAIDs with regional techniques—including thoracic epidural anesthesia, transversus abdominis plane (TAP) block, erector spinae plane (ESP) block, and wound infiltration—have shown promising results in enhancing postoperative pain control. Although thoracic epidural anesthesia remains the conventional standard, recent studies highlight the potential of newer regional blocks as effective and safer alternatives, especially in patients with contraindications to neuraxial techniques. Evidence-based application of regional anesthesia as part of a multimodal analgesia protocol can improve postoperative outcomes in liver surgery. Further high-quality randomized controlled trials are needed to define the optimal technique and guide clinical practice.