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Anesthesia and Pain Medicine 2010;5(3):267-272.
Published online July 31, 2010.
A comparison of postoperative pain in patients undergoing liver transplantation, donor hepatectomy, and a major hepatectomy for a tumor
Duk Kyung Kim, Seong Hwan Chang, Hae Won Lee, Ik Jin Yun, Ji Young Kim
1Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea.
2Department of Surgery, Konkuk University School of Medicine, Seoul, Korea.
Because liver transplantation (LT) essentially accompanies the deterioration, total absence, and recovery of hepatic function, and donor hepatectomy (DH) is performed in otherwise healthy individuals, we planned to compare the postoperative pain in patients undergoing LT, DH, and a major hepatectomy (MH) for a tumor.
Postoperatively, all patients were permitted to administer patient-controlled fentanyl with a standard dosing regimen. Breakthrough pain was treated with a 25microgram fentanyl bolus. Verbal rating scale (VRS) pain scores at rest (static) and during coughing (dynamic), total fentanyl consumption, and side effects were assessed at 2, 4, 6, 12, 24, and 48 h postoperatively.
Thirty patients (11, 10, and 9 in the MH, DH, and LT groups, respectively) were included in the study. The LT group showed a lower static pain VRS score 2, 4, 6, and 12 h postoperatively, and a lower dynamic pain VRS score 12, 24, and 48 h postoperatively than the MH group. Total fentanyl consumption was significantly less in the LT group than the other two groups throughout the study period. Postoperative nausea and vomiting were reduced significantly in the LT group than in the other two groups. No significant differences in postoperative fentanyl requirement, or static and dynamic pain, existed between the MH and DH groups.
LT patients experienced less static pain during the early postoperative period and less dynamic pain during the late postoperative period than MH patients. DH patients had similar pain intensity and postoperative fentanyl requirements to the MH patients.
Key Words: Hepatectomy, Liver transplantation, Postoperative pain

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