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

Autor: Alessandro De Cassai, Nicolò Sella, Federico Geraldini, Serkan Tulgar, Ali Ahiskalioglu, Burhan Dost, Silvia Manfrin, Yunus Emre Karapinar, Greta Paganini, Muzeyyen Beldagli, Vittoria Luoni, Busra Burcu Kucuk Ordulu, Annalisa Boscolo, Paolo Navalesi
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Korean Journal of Anesthesiology, Vol 76, Iss 1, Pp 34-46 (2023)
Druh dokumentu: article
ISSN: 2005-6419
2005-7563
DOI: 10.4097/kja.22366
Popis: Background Different regional anesthesia (RA) techniques have been used for laparoscopic 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-operation, postoperative nausea and vomiting (PONV), 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 PONV. Conclusions RA techniques are effective at reducing intraoperative opioid use, postoperative pain, and PONV in patients undergoing LC. Patients benefit the most from the bilateral paravertebral, ESP, quadratus lumborum, and TAP blocks.
Databáze: Directory of Open Access Journals
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