Anti-inflammatory Effects and Pharmacokinetics of Bupivacaine in Transversus Abdominis Plane Block for Living Liver Donors: A Prospective Randomized Clinical Trial

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-07-01 DOI:10.1016/j.transproceed.2025.06.003

Mehmet Ridvan Yalin , Mehmet Ali Erdogan , Muharrem Ucar , Muhammed Mehdi Uremis , Yusuf Ziya Colak , Emine Ozdemir , Yilmaz Ugur , Ulku Ozgul , Selim Erdogan , Osman Kacmaz , Duygu Demiroz , Huseyin Ilksen Toprak

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引用次数: 0

Abstract

Objective

Transversus abdominis plane (TAP) blocks have been reported to decrease postoperative pain and opioid use. Local anesthetics modulate the local and systemic inflammatory reaction. Our aim was to examine the effect of TAP block with bupivacaine on the anti-inflammatory response in living liver donors.

Methods

The randomized prospective clinical study was carried out on 72 living liver donors, aged 18 to 65 scheduled for right hepatectomy. TAP blocks were performed bilaterally with ultrasound guidance using 1.5 mg/kg of 0.5% bupivacaine for group 2. Group 1 patients were the control group. In both groups, blood samples were obtained preoperatively, 30 minutes and 2, 6, and 24 hours after the injection for cytokine measurement. In group 2, to examine the plasma bupivacaine level, blood samples were obtained preoperatively as well as 30 minutes and 1, 2, 6, 12, and 24 hours after injection. The primary outcome was to assess the effect of TAP block on the inflammatory response using cytokine levels.

Results

No difference was observed between cytokine levels (tumor necrosis factor-alpha, interleukin [IL]-1 and IL-6) between groups Significant positive correlations were observed between the plasma bupivacaine concentration and IL-1 and IL-6 levels at 2, 6, and 24 hours.

Conclusion

Although the TAP block did not affect the levels of cytokines significantly, a significant association was seen between the concentrations of plasma bupivacaine and the levels of IL-1 and IL-6 at 2, 6, and 24 hours. In contrast, the clinical significance of this association is still under investigation.

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布比卡因在活体肝供者经腹平面阻滞中的抗炎作用和药代动力学：一项前瞻性随机临床试验。

目的：经腹平面（TAP）阻滞已被报道可减少术后疼痛和阿片类药物的使用。局麻药调节局部和全身的炎症反应。我们的目的是研究布比卡因阻断TAP对活体肝供体抗炎反应的影响。方法：采用随机前瞻性临床研究，对72例18 ~ 65岁的活体肝供者行右肝切除术。2组在超声引导下双侧进行TAP阻滞，使用1.5 mg/kg 0.5%布比卡因。第一组患者为对照组。两组患者均于术前、注射后30分钟、注射后2、6、24小时采血，测定细胞因子。2组术前及注射后30分钟、1、2、6、12、24小时采血检测血浆布比卡因水平。主要结果是通过细胞因子水平评估TAP阻断对炎症反应的影响。结果：各组间细胞因子（肿瘤坏死因子- α、白细胞介素[IL]-1、IL-6）水平差异无统计学意义，2、6、24小时布比卡因血药浓度与IL-1、IL-6水平呈正相关。结论：尽管TAP阻断对细胞因子水平没有显著影响，但血浆布比卡因浓度与2、6和24小时IL-1和IL-6水平之间存在显著相关性。相比之下，这种关联的临床意义仍在研究中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.