• Paul Karanicolas, Sean Cleary, Paul McHardy, Stuart McCluskey, Jason Sawyer, Salima Ladak, Calvin Law, Alice Wei, Natalie Coburn, Raynauld Ko, Joel Katz, Alex Kiss, James Khan, Srinivas Coimbatore, Jenny Lam-McCulloch, and Hance Clarke.
• Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada. paul.karanicolas@sunnybrook.ca.
• Trials. 2014 Jan 1;15:241.

BackgroundThe current standard for pain control following liver surgery is intravenous, patient-controlled analgesia (IV PCA) or epidural analgesia. We have developed a modification of a regional technique called medial open transversus abdominis plane (MOTAP) catheter analgesia. The MOTAP technique involves surgically placed catheters through the open surgical site into a plane between the internal oblique muscle and the transverse abdominis muscle superiorly. The objective of this trial is to assess the efficacy of this technique.Methods/DesignThis protocol describes a multicentre, prospective, blinded, randomized controlled trial. One hundred and twenty patients scheduled for open liver resection through a subcostal incision will be enrolled. All patients will have two MOTAP catheters placed at the conclusion of surgery. Patients will be randomized to one of two parallel groups: experimental (local anaesthetic through MOTAP catheters) or placebo (normal saline through MOTAP catheters). Both groups will also receive IV PCA. The primary endpoint is mean cumulative postoperative opioid consumption over the first 2 postoperative days (48 hours). Secondary outcomes include pain intensity, patient functional outcomes, and the incidence of complications.DiscussionThis trial has been approved by the ethics boards at participating centres and is currently enrolling patients. Data collection will be completed by the end of 2014 with analysis mid-2015 and publication by the end of 2015.Trial RegistrationThe study is registered with http://clinicaltrials.gov ( NCT01960049; 23 September 2013).

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