Analgesia for living donor liver transplant: a systematic review of recent trials

The 2022 enhanced recovery after surgery guidelines for liver transplant surgery highlighted a scarcity of evidence concerning perioperative pain management, with a low quality of evidence in support of transversus abdominis plane (TAP) block. We conducted this review to investigate the available evidence published in the last 2 years, hoping to expand the current knowledge for optimal pain control following liver transplant surgery.

Our findings suggest that bilateral erector spinae plane block, subcostal TAP block, and intrathecal morphine are viable new adjuncts to the current perioperative pain management strategies and merit further investigation.

Little new data are available since the last guidelines; regional anesthesia techniques appear to offer good pain management when part of a multimodal and balanced analgesic approach to liver transplant surgery.