Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 13:18:2409-2416.
doi: 10.2147/JPR.S516772. eCollection 2025.

Effect of Low Thoracic Paravertebral Block via the Arcuate Ligament Under Direct Visualization on the Quality of Postoperative Recovery After Laparoscopic Donor Nephrectomy for Living-Donor Kidney Transplantation: Study Protocol for a Prospective, Blinded, Randomized Controlled Clinical Trial

Lingli Cui #  1 , Yichen Zhu #  2   3 , Shen Liu  1 , Liang Zhang  1 , Qian Zhu  1 , Yun Wang  1 , Danxu Ma  1
Affiliations

Effect of Low Thoracic Paravertebral Block via the Arcuate Ligament Under Direct Visualization on the Quality of Postoperative Recovery After Laparoscopic Donor Nephrectomy for Living-Donor Kidney Transplantation: Study Protocol for a Prospective, Blinded, Randomized Controlled Clinical Trial

Lingli Cui et al. J Pain Res. .

Abstract

Introduction: Laparoscopic donor nephrectomy (LDN) is the standard procedure for donor nephrectomy for living kidney transplantation. Compared with traditional open surgery, the laparoscopic techniques have been developed to significantly reduce postoperative pain and accelerate postoperative recovery; however, most donors still experience more than moderate pain after surgery. Ensuring maximum perioperative safety and postoperative pain control for donors remains a top priority for LDN. Our group reported a novel blockade technique that allows local anesthetic to be injected directly to reach the low thoracic paravertebral space under direct laparoscopic observation via the arcuate ligament to achieve somatic and visceral pain analgesia; this technique has been successfully applied to patients undergoing retroperitoneal laparoscopic nephrectomy. We hypothesized that compared with the transversus abdominis plane (TAP) block, low thoracic paravertebral block (TPVB) via the arcuate ligament under direct vision would reduce the consumption of postoperative opioids and improve the quality of postoperative recovery of donors after LDN.

Methods/analysis: This study is a prospective blind, randomized, controlled clinical trial with a concealed allocation of donors scheduled to undergo elective LDN 1:1 to receive either a low TPVB via the arcuate ligament under direct vision or a TAP block. This study will recruit a total of 82 living kidney donors. The primary outcome is the 15-item recovery quality scale (QoR-15) score at 24 hours after surgery.

Ethics and dissemination: This trial was approved by the Ethics Committee of Beijing Friendship Hospital, Capital Medical University. This trial study protocol was approved on 30 November 2024. The trial started recruiting patients after being registered on the Chinese Clinical Trial Registry.

Trial registration number: ChiCTR2400094612.

Keywords: arcuate ligament; laparoscopy; living donor nephrectomy; thoracic paravertebral block.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

References

    1. Rocca X, Espinoza O, Hidalgo F, et al. Laparoscopic nephrectomy: safe and comfortable surgical alternative for living donors and for good results of graft function. Transplant Proc. 2005;37(8):3349–3350. doi:10.1016/j.transproceed.2005.09.140 - DOI - PubMed
    1. Axelrod DA, Schnitzler MA, Xiao H, et al. An economic assessment of contemporary kidney transplant practice. Am J Transplant. 2018;18(5):1168–1176. doi:10.1111/ajt.14702 - DOI - PubMed
    1. Segev DL, Muzaale AD, Caffo BS, et al. Perioperative mortality and long-term survival following live kidney donation. JAMA. 2010;303(10):959–966. doi:10.1001/jama.2010.237 - DOI - PubMed
    1. Ratner LE, Ciseck LJ, Moore RG, et al. Laparoscopic live donor nephrectomy. Transplantation. 1995;60(9):1047–1049. - PubMed
    1. Yuan H, Liu L, Zheng S, et al. The safety and efficacy of laparoscopic donor nephrectomy for renal transplantation: an updated meta-analysis. Transplant Proc. 2013;45(1):65–76. doi:10.1016/j.transproceed.2012.07.152 - DOI - PubMed

LinkOut - more resources