PROSPECT provides clinicians with supporting arguments for and against the use of various interventions in postoperative pain based on published evidence and expert opinion. Clinicians must make judgements based upon the clinical circumstances and local regulations. At all times, local prescribing information for the drugs referred to must be consulted.
Grades of recommendation are assigned according to the overall level of evidence on which the recommendations are based, which is determined by the quality and source of evidence: Relationship between quality and source of evidence, levels of evidence and grades of recommendation.
The most frequent approaches for open liver resection include the use of a right subcostal incision or a reversed L-shaped incision (Chang 2010). Irrespective of the approach, the procedure can be associated with significant postoperative pain. Effective pain control can facilitate early mobilisation and reduce postoperative complications (Yip 2016). Adequate pain management is a key to the success of an enhanced recovery after surgery (ERAS) program in liver resection (Day 2019; Joshi 2019). However, the optimal pain management regimen for open liver resection remains controversial.
The aim of the PROSPECT review was to evaluate the available literature and develop recommendations on the management of pain after open liver resection in adults.
NSAIDs, non-steroidal anti-inflammatory drugs; TAP, transversus abdominis plane
NSAIDs, non-steroidal anti-inflammatory drugs
Analgesic interventions that are not recommended for pain management in patients undergoing open liver resection.
Further high-quality randomised controlled trials are needed to confirm and clarify the efficacy of the recommended analgesic regimen in the context of an enhanced recovery program.