Impact of liver disease severity on postoperative pain after living donor liver transplantation: a prospective observational study
Background : Managing pain after liver transplantation presents unique challenges. The severity of this pain may correspond to elevated endogenous opioid peptide levels, which in turn depend on the severity of liver disease, as represented by the Model for End-Stage Liver Disease (MELD) score. Hence...
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The Korean Society for Transplantation
2025-06-01
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| Series: | Clinical Transplantation and Research |
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| Online Access: | https://www.ctrjournal.org/journal/view.html?doi=10.4285/ctr.24.0054 |
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| author | Priyanka Chuttani Gaurav Sindwani Viniyendra Pamecha Nihar Mohapatra Mahesh Kumar Arora |
| author_facet | Priyanka Chuttani Gaurav Sindwani Viniyendra Pamecha Nihar Mohapatra Mahesh Kumar Arora |
| author_sort | Priyanka Chuttani |
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| description | Background : Managing pain after liver transplantation presents unique challenges. The severity of this pain may correspond to elevated endogenous opioid peptide levels, which in turn depend on the severity of liver disease, as represented by the Model for End-Stage Liver Disease (MELD) score. Hence, this study aimed to assess the difference in fentanyl consumption after liver transplantation between patients with high and low MELD scores. Methods : Patients meeting the inclusion criteria and scheduled for living donor liver transplantation were prospectively recruited. A standard anesthesia protocol was followed for intraoperative management. Postoperatively, intravenous patient-controlled analgesia was initiated. Visual analogue scores, fentanyl consumption, sedation levels, and complications such as pruritus, nausea, and vomiting were recorded. Results : A total of 40 patients were included. The patients were divided into low-MELD (<25) and high-MELD (≥25) groups, with 20 patients in each. Fentanyl consumption was significantly higher in the low-MELD group on both postoperative day (POD) 1 (118.00±11.16 vs. 62.25±11.16 μg, P=0.001) and POD 2 (59.00±7.41 vs. 18.00±7.41 μg, P<0.001). Similarly, pain at rest was significantly higher in the low-MELD group on POD 1 (39.29±1.01 vs. 35.70±1.01, P=0.019) and POD 2 (28.21±1.01 vs. 22.78±1.00, P=0.001). Conclusions: Among patients with chronic liver disease undergoing living donor liver transplantation, postoperative fentanyl consumption and pain scores were significantly lower in those with a high MELD score compared to patients with a low MELD score. |
| format | Article |
| id | doaj-art-22e8f0e7b05c43bd83edfe04471cadf7 |
| institution | Matheson Library |
| issn | 3022-6783 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | The Korean Society for Transplantation |
| record_format | Article |
| series | Clinical Transplantation and Research |
| spelling | doaj-art-22e8f0e7b05c43bd83edfe04471cadf72025-06-27T08:18:48ZengThe Korean Society for TransplantationClinical Transplantation and Research3022-67832025-06-0139214214910.4285/ctr.24.0054ctr.24.0054Impact of liver disease severity on postoperative pain after living donor liver transplantation: a prospective observational studyPriyanka Chuttani0Gaurav Sindwani1Viniyendra Pamecha2Nihar Mohapatra3Mahesh Kumar Arora4Department of Anaesthesiology, Institute of Liver and Biliary Sciences, New Delhi, IndiaDepartment of Anaesthesiology, Institute of Liver and Biliary Sciences, New Delhi, IndiaDepartment of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Institute of Liver and Biliary Sciences, New Delhi, IndiaDepartment of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Institute of Liver and Biliary Sciences, New Delhi, IndiaDepartment of Anaesthesiology, Institute of Liver and Biliary Sciences, New Delhi, IndiaBackground : Managing pain after liver transplantation presents unique challenges. The severity of this pain may correspond to elevated endogenous opioid peptide levels, which in turn depend on the severity of liver disease, as represented by the Model for End-Stage Liver Disease (MELD) score. Hence, this study aimed to assess the difference in fentanyl consumption after liver transplantation between patients with high and low MELD scores. Methods : Patients meeting the inclusion criteria and scheduled for living donor liver transplantation were prospectively recruited. A standard anesthesia protocol was followed for intraoperative management. Postoperatively, intravenous patient-controlled analgesia was initiated. Visual analogue scores, fentanyl consumption, sedation levels, and complications such as pruritus, nausea, and vomiting were recorded. Results : A total of 40 patients were included. The patients were divided into low-MELD (<25) and high-MELD (≥25) groups, with 20 patients in each. Fentanyl consumption was significantly higher in the low-MELD group on both postoperative day (POD) 1 (118.00±11.16 vs. 62.25±11.16 μg, P=0.001) and POD 2 (59.00±7.41 vs. 18.00±7.41 μg, P<0.001). Similarly, pain at rest was significantly higher in the low-MELD group on POD 1 (39.29±1.01 vs. 35.70±1.01, P=0.019) and POD 2 (28.21±1.01 vs. 22.78±1.00, P=0.001). Conclusions: Among patients with chronic liver disease undergoing living donor liver transplantation, postoperative fentanyl consumption and pain scores were significantly lower in those with a high MELD score compared to patients with a low MELD score.https://www.ctrjournal.org/journal/view.html?doi=10.4285/ctr.24.0054anesthesiafentanylintensive care unitliver transplantationpain |
| spellingShingle | Priyanka Chuttani Gaurav Sindwani Viniyendra Pamecha Nihar Mohapatra Mahesh Kumar Arora Impact of liver disease severity on postoperative pain after living donor liver transplantation: a prospective observational study Clinical Transplantation and Research anesthesia fentanyl intensive care unit liver transplantation pain |
| title | Impact of liver disease severity on postoperative pain after living donor liver transplantation: a prospective observational study |
| title_full | Impact of liver disease severity on postoperative pain after living donor liver transplantation: a prospective observational study |
| title_fullStr | Impact of liver disease severity on postoperative pain after living donor liver transplantation: a prospective observational study |
| title_full_unstemmed | Impact of liver disease severity on postoperative pain after living donor liver transplantation: a prospective observational study |
| title_short | Impact of liver disease severity on postoperative pain after living donor liver transplantation: a prospective observational study |
| title_sort | impact of liver disease severity on postoperative pain after living donor liver transplantation a prospective observational study |
| topic | anesthesia fentanyl intensive care unit liver transplantation pain |
| url | https://www.ctrjournal.org/journal/view.html?doi=10.4285/ctr.24.0054 |
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