Intravenous patient-controlled fentanyl with and without transversus abdominis plane block in cirrhotic patients post liver resection

Figures & data

Table 1 Hemodynamic differences between IVPCA and IVPCA + TAP groups

Study variable	Groups	Mean ± SD	t-test	P-value
HR POD 1	IVPCA IVPCA + TAP	94.29±13.4 79.52±10.6	3.98	<0.01
SBP POD 1	IVPCA IVPCA + TAP	121.7±13.12 108.4±10.3	3.68	<0.01
DBP POD 1	IVPCA IVPCA + TAP	77±8.69 70±7.64	2.76	<0.01
HR POD 2	IVPCA IVPCA + TAP	94.35±15.3 82.2±14.4	2.59	<0.01
SBP POD 2	IVPCA IVPCA + TAP	127.06±13 106.25±12.8	5.08	<0.01
DBP POD 2	IVPCA IVPCA + TAP	74.53±9.35 67.08±8.59	2.64	<0.01
HR POD 3	IVPCA IVPCA + TAP	93.69±14.5 83.96±9.27	2.59	<0.05
SBP POD 3	IVPCA IVPCA + TAP	124.12±15.74 109.38±12.19	3.38	<0.01
DBP POD 3	IVPCA IVPCA + TAP	73.24±6.6 71.25±7.98	0.84	>0.05

Notes: Data are presented as the mean ± SD. The Student’s t-test was used to compare HR, SBP, and DBP. P<0.05 was considered to be statistically significant and P<0.01 was considered to be highly statistically significant.

Abbreviations: DBP, diastolic blood pressure; HR, heart rate; IVPCA, intravenous patient-controlled analgesia; SBP, systolic blood pressure; SD, standard deviation; POD, postoperative day; TAP, transversus abdominis plane.

Table 2 Postoperative sedation scores during follow-up in the IVPCA and IVPCA + TAP groups

Time	Groups	Median (IQR)	Mann–Whitney U test	P-value
POD 1	IVPCA IVPCA + TAP	4 (3–4) 3 (1–5)	0.25	>0.05
POD 2	IVPCA IVPCA + TAP	2 (1–2) 2 (1–2)	0.21	>0.05
POD 3	IVPCA IVPCA + TAP	2 (2–2) 1 (1–2)	3.09	<0.01

Notes: Data are presented as the median and IQR. The Mann–Whitney U test was used to compare postoperative sedation scores. P<0.01 was considered to be highly statistically significant.

Abbreviations: IVPCA, intravenous patient-controlled analgesia; POD, postoperative day; TAP, transversus abdominis plane; IQR, interquartile range (25th percentile to 75th percentile).

Table 3 Differences in postoperative pain scores between the IVPCA and IVPCA + TAP groups

Time	Groups	Median (IQR)	Mann–Whitney U test	P-value
6 hours on POD 1	IVPCA IVPCA + TAP	3 (3–4) 5 (4–7)	3.51	<0.01
12 hours on POD 1	IVPCA IVPCA + TAP	6 (6–7) 5 (2–6)	3.02	<0.01
18 hours on POD 1	IVPCA IVPCA + TAP	7 (6–7) 5 (3–7)	2.76	<0.01
24 hours on POD 1	IVPCA IVPCA + TAP	7 (6–7) 5 (4–5)	4.25	<0.01
POD 2	IVPCA IVPCA + TAP	7 (6–7) 3 (2–4)	4.45	<0.01
POD 3	IVPCA IVPCA + TAP	6 (5–7) 3 (2–5)	4.51	<0.01

Notes: Data are presented as the median and IQR (25th percentile to 75th percentile). The Mann–Whitney U test was used for comparisons. P<0.01 indicates a highly statistically significant difference.

Abbreviations: IVPCA, intravenous patient-controlled analgesia; POD, postoperative day; TAP, transversus abdominis plane; IQR, interquartile range (25th percentile to 75th percentile).

Table 4 Conventional blood tests for the IVPCA group

Study variables	Preoperative	POD 1	POD 2	POD 3	Repeated-measures ANOVA	P-value
INR	1.18±0.1	1.19±0.1	1.3±0.1**	1.4±0.1**	1,381.61	<0.01
Platelets	201±90.21	195.6±99.4	182.7±88.2	171.5±82.5**	8.15	<0.05
PC (%)	82.06±12.19	80.68±12.3*	67.9±11.0**	63.9±13.6**	764.21	<0.01
Hemoglobin (g/dL)	12.18±1.16	12.7±1.5	11±1.2**	11.8±1.4	2,785.32	<0.01
Hematocrit (%)	36.18±3.24	38.4±5*	36.7±5.8	35.7±4	2,235.01	<0.01

Notes: The data are presented as the mean and standard deviation. Repeated-measures ANOVA was used for INR, PC, hemoglobin, and hematocrit, and the Friedman test was used for platelets. P<0.05 was considered to be statistically significant and P<0.01 was considered to be highly statistically significant.

* Significant with 1st reading (Preop)

** Highly significant with 1st reading (Preop).

Abbreviations: ANOVA, analysis of variance; INR, International Normalized Ratio; PC, prothrombin concentration; POD, postoperative day; IVPCA, intravenous patient-controlled analgesia; Preop, preoperative.

Table 5 Conventional blood tests for the IVPCA + TAP group

Study variables	Preoperative	POD 1	POD 2	POD 3	Repeated-measures ANOVA	P-value
INR	1.07±0.22	1.2±0.19*	1.49±0.26**	1.54±0.25**	1,849.44	<0.01
Platelets	205.24±84.2	193.11±88.9	187±106	149.59±62*	21.56	<0.01
PC (%)	90.41±14.9	70±18.16**	49.5±12.6**	47.1±13.4**	736	<0.01
Hemoglobin (g/dL)	13.29±1.57	12.14±1.7**	12.25±1.8*	11.14±1.7**	1,311.95	<0.01
Hematocrit (%)	37.83±4.39	36.69±5.09	37.15±55	34.11±5.4	1,396.22	<0.01

Notes: The data are presented as the mean and standard deviation. Repeated-measures ANOVA was used for INR, PC, hemoglobin, and hematocrit, and the Friedman test was used for platelets. P<0.05 was considered to be statistically significant and P<0.01 was considered to be highly statistically significant.

* Significant with 1st reading (Preop)

** Highly significant with 1st reading (Preop).

Abbreviations: ANOVA, analysis of variance; INR, International Normalized Ratio; PC, prothrombin concentration; POD, postoperative day; IVPCA, intravenous patient-controlled analgesia; TAP, transversus abdominis plane block; Preop, preoperative.

Figure 1 Bar chart showing the mean and standard deviation values for fentanyl consumption in the IVPCA and IVPCA + TAP groups. P<0.05 indicates statistical significance. A, B, and C show fentanyl consumption on day 1, 2, and 3, respectively.

Abbreviations: IVPCA, intravenous patient-controlled analgesia; TAP, transversus abdominis plane.

Table 6 Differences in fentanyl consumption in micrograms between the IVPCA and IVPCA + TAP groups

Fentanyl consumption	Group	Mean	SD	t-test	P-value
POD 1	IVPCA + TAP IVPCA	1,000.80 1,254.6	61.57 287.15	3.6	<0.01
POD 2	IVPCA + TAP IVPCA	995.80 1,293.29	65.92 445.10	2.75	<0.05
POD 3	IVPCA + TAP IVPCA	956.80 1,182.24	102.23 372.41	2.46	<0.05

Notes: The data are presented as the mean and standard deviation. The Student’s t-test was used to compare fentanyl consumption in the two groups. P<0.05 was considered to be statistically significant and P<0.01 was considered to be highly statistically significant.

Abbreviations: IVPCA, intravenous patient-controlled analgesia; POD, postoperative day; TAP, transversus abdominis plane; SD, standard deviation.

Figure 2 Bar chart showing the mean and standard deviation values for ICU stay between the IVPCA and IVPCA + TAP groups. P<0.05 indicates statistical significance.

Abbreviations: IVPCA, intravenous patient-controlled analgesia; TAP, transversus abdominis plane; ICU, intensive care unit.

Table 7 Differences in satisfaction scores between the IVPCA and IVPCA + TAP groups

Satisfaction score	IVPCA + TAP	IVPCA	χ^2 test	P-value
Excellent	5 (20.0)	4 (16.0)	0.36	>0.05
Good	9 (36.0)	11 (44.0)
Fair	11 (44.0)	10 (40.0)
Poor	0 (0.0)	0 (0.0)

Notes: The data are presented as the number (%). P-value >0.05 using the χ² test.

Abbreviations: IVPCA, intravenous patient-controlled analgesia; TAP, transversus abdominis plane.