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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