Review 2023 · 28 atıf

Single-shot regional anesthesia for laparoscopic cholecystectomies: a systematic review and network meta-analysis

De Cassai, Alessandro, Sella, Nicolo, Geraldini, Federico, Tulgar, Serkan, Ahiskalioglu, Ali, Dost, Burhan, Manfrin, Silvia, Karapinar, Yunus Emre, Paganini, Greta, Beldagli, Muzeyyen, Luoni, Vittoria, Ordulu, Busra Burcu Kucuk, Boscolo, Annalisa, Navalesi, Paolo

Özet

Background: Different regional anesthesia (RA) techniques have been used for laparo-scopic cholecystectomy (LC), but there is no consensus on their comparative effectiveness. Our objective was to evaluate the effect of RA techniques on patients undergoing LC using a network meta-analysis approach.Methods: We conducted a systematic review and network meta-analysis. We searched PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science (Science and Social Science Citation Index) using the following PICOS criteria: (P) adult patients undergoing LC; (I) any RA single-shot technique with injection of local anesthetics; (C) placebo or no intervention; (O) postoperative opioid consumption expressed as morphine milligram equivalents (MME), rest pain at 12 h and 24 h post -op-eration, postoperative nausea and vomiting (PONY), length of stay; and (S) randomized controlled trials.Results: A total of 84 studies were included. With the exception of the rectus sheath block (P = 0.301), the RA techniques were superior to placebo at reducing opioid consumption. Regarding postoperative pain, the transversus abdominis plane (TAP) block (-1.80 on an 11-point pain scale) and erector spinae plane (ESP) block (-1.33 on an 11-point pain scale) were the most effective at 12 and 24 h. The TAP block was also associated with the greatest reduction in PONY.Conclusions: RA techniques are effective at reducing intraoperative opioid use, postoper-ative pain, and PONY in patients undergoing LC. Patients benefit the most from the bilat-eral paravertebral, ESP, quadratus lumborum, and TAP blocks.

Anahtar Kelimeler

Cholecystectomy Conduction anesthesia Laparoscopic cholecystectomy Lap-aroscopy Local anesthesia Meta-analysis ABDOMINIS PLANE BLOCK POSTOPERATIVE PAIN RELIEF QUADRATUS LUMBORUM BLOCK PORT-SITE INFILTRATION RECTUS SHEATH BLOCK DOUBLE-BLIND INTRAPERITONEAL BUPIVACAINE ANALGESIC EFFICACY PREINCISIONAL INFILTRATION MULTIMODAL ANALGESIA

WoS Kategorileri

Anesthesiology

Künye

Dergi: KOREAN JOURNAL OF ANESTHESIOLOGY
Yıl: 2023
Cilt: 76
Sayı: 1
Sayfa: 34-46
ISSN: 2005-6419
eISSN: 2005-7563
DOI: 10.4097/kja.22366
WoS UID: WOS:000930507400005

Yayını aç (DOI)