Prof. Justin Sangwook KO
Director of Scientific Affairs
Korean Society of Anesthesiologists
Dr. Ko is the Associate Professor at the Sungkyunkwan University School of Medicine, Samsung Medical Center, Department of Anesthesiology & Pain Medicine in Seoul Korea. He is currently the Director of Scientific Affairs Committee of Korean Society of Anesthesiologists (KSA) and Director of International Affairs of Korean Society of Transplantation Anesthesiologists (KSTA) and the Director of Planning of Korean Society of Regional Anesthesia (KSRA).
He has specialized knowledge in liver transplant anesthesia and regional anesthesia. He has conducted many clinical trials and basic researches, and published more than 100 peer reviewed articles. He is clinically active in the operating room where he teaches and mentors students and residents of anesthesiology.
Living liver donors are healthy individuals who undergo major surgery without any direct therapeutic benefit from the procedure. Severe postoperative pain can cause substantial physical and psychological distress in donors and impair functional recovery. Therefore, effective postoperative pain control should be an integral part of donor management.
At our institution, we have sequentially evaluated several modalities of postoperative pain control in living liver donors including epidural analgesia, intrathecal morphine (ITM) with intravenous patient-controlled analgesia (PCA), intravenous PCA alone, continuous wound infusion of ropivacaine, bilateral single-injection erector spinae plane block (ESPB), bilateral continuous ESBP with catheter techniques, and most recently, bilateral quadratus lumborum block type 2. A single 400 μg dose of ITM is currently used as the standard protocol because it is relatively easy to administer while providing effective analgesia for up to 30 hours after surgery. However, limitations include frequent postoperative nausea and vomiting, pruritus, and importantly, the potential for delayed respiratory depression. Therefore, our transplantation anesthesia team is seeking to identify an alternative to ITM that would be as effective but produce fewer adverse effects