Effectiveness of continuous erector spinae plane blocks for postoperative analgesia for living donor liver transplantation

Erector spinae block (ESP) was first described in 2016 by Forero et al as a regional anesthetic technique. Local anesthetic injected into this erector spinae fascial plane spreads in a craniocaudal fashion over several levels and to the thoracic paravertebral space thereby targeting the dorsal and ventral rami of the spinal nerve. Thus it has the potential to provide both somatic and visceral sensory blockade, which would make it an ideal regional anesthetic technique for abdominal surgery. The significant advantages of ESP block compared to epidural or paravertebral block relate to the relative ease, simplicity, and safety of the block with fewer risks of pneumothorax. The use of an open surgical technique to identify the TAP accurately during the closure of the abdominal wall to perform regional anesthesia blocks and insert catheters for continuous analgesia was used by some investigators who stated that open TAP blocks are safe and reduce postoperative opioid requirements and sedation after liver resection and other surgeries as hemi‑colectomies, liver transplant, and emergency laparotomy, respectively. The primary goal of this study will be the comparison of the analgesic effect of ESP block and TAP block in living donor liver transplant. The secondary goal was to assess the total postoperative fentanyl consumption, postoperative nausea and vomiting, and time to first request for analgesia according to 10 cm VAS within 24h after surgery.