Comparing Spinal Anesthesia With Intrathecal Morphine Versus Continuous Thoracic Epidural Analgesia for Faster Recovery After Liver Surgery

What this Trial Is About

Researchers are comparing spinal anesthesia to epidural anesthesia in adults undergoing liver resection surgery to see which method better controls blood pressure and reduces the need for intravenous fluids after surgery. The study aims to determine if spinal anesthesia offers similar pain relief benefits as epidural anesthesia while promoting faster recovery. This trial addresses concerns about fluid balance, respiratory complications, and safety related to epidural anesthesia in liver surgery patients. Participants receive either spinal anesthesia with intrathecal morphine or continuous thoracic epidural analgesia during surgery. The spinal anesthesia group receives a high-spinal dose of bupivacaine with intrathecal morphine before surgery and uses intravenous patient-controlled hydromorphone for pain afterward. The epidural group receives bupivacaine and hydromorphone through a thoracic epidural catheter before and after surgery, with continuous infusion for up to 72 hours postoperatively. During the study, participants are monitored for fluid and blood product use, pain levels at rest and with movement, opioid consumption, and various recovery measures such as mobilization, gastrointestinal function, and urinary catheter removal. Safety outcomes like respiratory depression, sedation, delirium, and complications are also tracked. The study collects data up to 30 days after surgery, including hospital stay length and postoperative complications, to evaluate recovery quality and analgesic effects.

Spinal Anesthesia For Enhanced Recovery After Liver Surgery