Comparing Continuous Erector Spinae Plane Block and Thoracic Epidural Analgesia for Pain Control After Open Liver Surgery

What this Trial Is About

Researchers are evaluating pain control methods for patients undergoing elective open liver resection, a surgery often followed by severe postoperative pain. This trial compares continuous erector spinae plane block ESPB using a programmed intermittent bolus regimen with thoracic epidural analgesia TEA, the current standard, focusing on pain relief, safety, and effects on breathing. The study aims to determine if ESPB is not worse than TEA in controlling pain at rest 72 hours after surgery. Participants will be randomly assigned to two groups. One group will receive bilateral ESPB catheters placed at the T7 level with ropivacaine delivered intermittently every 3 hours for 72 hours. The other group will have a thoracic epidural catheter inserted at T7-T8 with a continuous ropivacaine infusion for 72 hours. Both groups will also receive general anesthesia and systemic pain medications including intravenous paracetamol and nefopam. Treatments and monitoring continue during the 72-hour postoperative period. During the study, participants will have their pain measured at rest and during coughing at multiple time points up to 72 hours after surgery. Researchers will also track morphine use, hemodynamic stability, sleep quality, gastrointestinal recovery, adverse events like nausea or catheter issues, and length of hospital stay. The main result is pain intensity at 24 hours post-surgery. Safety and effectiveness data will be collected until the study ends in August 2026.

Erector Spinae Plane Block Versus Thoracic Epidural Analgesia for Open Liver Resection