The Effects of Local Infiltration Versus Epidural Following Liver Resection 2 (LIVER 2)
A Randomised Trial of Peri-operative Nerve Block and Continuous Infusion of Local Anaesthetic Via Wound Catheter Versus Epidural in Patients Undergoing Open Liver Resection.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Lothian
-
Edinburgh, Lothian, United Kingdom, EH16 4SA
- Royal Infirmary of Edinburgh
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients undergoing open hepatic resection for benign or malignant conditions.
Exclusion Criteria:
- Patients with contraindication to either epidural or wound catheter techniques.
- Inability to give written, informed consent.
- Jaundice (Bilirubin > 100 μmol/L)
- Liver resection combined with secondary surgical procedure.
- Age < 18 years
- Pregnant women
- patients on long term opiates for chronic pain
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: Wound catheter
|
Wound catheter, placed at end of procedure, prior to closure.
To be kept in for 48 hours.
Other Names:
|
|
ACTIVE_COMPARATOR: Epidural
Standard epidural, pre-operative insertion, to be run for 48 hours
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Length of stay
Time Frame: Measurement made on day of discharge which is expected to be on average bewteen 5 and 10 days after surgery.
|
Number of days (to nearest half day) patients stay in hospital.
|
Measurement made on day of discharge which is expected to be on average bewteen 5 and 10 days after surgery.
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pain Scores
Time Frame: Performed daily at 0900 hours. On the day of surgery pain scores will be performed at 2, 6 and 12 hours post surgery.
|
Visual analogue scores of pain experienced.
|
Performed daily at 0900 hours. On the day of surgery pain scores will be performed at 2, 6 and 12 hours post surgery.
|
|
Molecular response to surgery
Time Frame: Days 0, 1 and 3
|
HMGB1, RAGE and cytokines
|
Days 0, 1 and 3
|
|
Central Venous Pressure
Time Frame: During liver transection
|
Mean Central Venous Pressure during liver transection will be quantified and compared between groups.
|
During liver transection
|
|
Estimated Blood Loss
Time Frame: Intra-operative
|
Intra-operative
|
|
|
Operative field asessment
Time Frame: During liver transection
|
During liver transection
|
|
|
Pringle time
Time Frame: Intra-operative
|
Intra-operative
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Quality of Life (EQ-5D)
Time Frame: Pre-operative, 2 weeks post-operative, 4-6 weeks post-operative
|
Pre-operative, 2 weeks post-operative, 4-6 weeks post-operative
|
|
Morphine consumption
Time Frame: Day of surgery and postoperative days 1-7
|
Day of surgery and postoperative days 1-7
|
|
IV Fluid volume
Time Frame: Day of Surgery and postoperative days 1-7
|
Day of Surgery and postoperative days 1-7
|
|
Complications
Time Frame: day of surgery and post-operative days 1-30
|
day of surgery and post-operative days 1-30
|
|
Post-operative blood tests (FBC, U&E, LFTs, coag)
Time Frame: Post-operative days 1-7
|
Post-operative days 1-7
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
General Publications
- Revie EJ, McKeown DW, Wilson JA, Garden OJ, Wigmore SJ. Randomized clinical trial of local infiltration plus patient-controlled opiate analgesia vs. epidural analgesia following liver resection surgery. HPB (Oxford). 2012 Sep;14(9):611-8. doi: 10.1111/j.1477-2574.2012.00490.x. Epub 2012 Jun 10.
- Hughes MJ, Harrison EM, Peel NJ, Stutchfield B, McNally S, Beattie C, Wigmore SJ. Randomized clinical trial of perioperative nerve block and continuous local anaesthetic infiltration via wound catheter versus epidural analgesia in open liver resection (LIVER 2 trial). Br J Surg. 2015 Dec;102(13):1619-28. doi: 10.1002/bjs.9949. Epub 2015 Oct 8.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
First Posted
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- 2012/R/SU/01 - LIVER 2 Trial
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