Comparação entre três técnicas regionais de analgesia pós-operatória em crianças com ropivacaína

Caetano, Ana Maria Menezes; Falbo, Gilliatt Hanois; Lima, Luciana Cavalcanti

doi:10.1590/s0034-70942006000600001

Cited by 6 publications

(5 citation statements)

References 22 publications

(50 reference statements)

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“…Finally, 69 eligible RCTs were included for qualitative and quantitative analyses. 22–90 A PRISMA flow diagram of the evidence selection process is presented in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Eight cases of lower extremity weakness were reported, including 6 cases in the caudal block and 2 cases of femoral nerve palsy in landmark-based II-IHB. Of the 6 cases in the caudal block, 3 had Bromage scale I motor block that fully recovered within 4 hours, 63 2 were unable to stand during the first 2.5 hours, 33 and 1 was unable to move the legs for an unreported duration. 43 The 2 cases of femoral nerve palsy in landmark-based II-IHB had gait disturbance after surgery, but fully recovered within 2.5 hours and 3.5 hours.…”

Section: Resultsmentioning

confidence: 99%

“…TAPB had the greatest PONV reduction effect when compared to the systemic opioid group. The randomeffects ranking order of PONV reduction was as follows: TAPB, QLB, WI, landmark-based II-IHB, caudal block, ultrasound-guided II-IHB, control, and systemic opioid analgesics ( 63 2 were unable to stand during the first 2.5 hours, 33 and 1 was unable to move the legs for an unreported duration. 43 The 2 cases of femoral nerve palsy in landmark-based II-IHB had gait disturbance after surgery, but fully recovered within 2.5 hours and 3.5 hours.…”

Section: Anesthesia and Analgesiamentioning

confidence: 99%

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Analgesic Effects of Regional Analgesic Techniques in Pediatric Inguinal Surgeries: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Hung

Bai

Tsai

et al. 2023

Anesthesia &Amp; Analgesia

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BACKGROUND: Various regional analgesic techniques have been used in pediatric inguinal surgery to facilitate postoperative recovery. However, each technique's relative performance was undetermined owing to the lack of quantitative analysis. Methods: We systematically searched MEDLINE, Cochrane Library, EMBASE, and Web of Science for randomized controlled trials that compared regional analgesia in pediatric inguinal surgeries. After critical study screening and selection, a random-effects network meta-analysis was performed. The primary outcome was the time to the first rescue analgesic after surgery, and the secondary outcomes were the number of patients requiring rescue analgesics after surgery, postoperative pain scores, incidence of postoperative nausea and vomiting, and other adverse events. RESULTS: This network meta-analysis included 69 randomized controlled trials (4636 patients) that compared 10 regional analgesic techniques. Our study revealed that the quadratus lumborum and transversus abdominis plane blocks had the longest time to the first rescue analgesic after pediatric inguinal surgeries, by 7.7 hours (95% confidence interval [CI], 5.0-10.3) and 6.0 hours (95% CI, 3.9-8.2) when compared with the control group, respectively. In the subgroup involving only inguinal hernia repair, the quadratus lumborum block significantly prolonged the time to the first rescue analgesic than all other regional analgesics. In contrast, in the subgroup involving orchidopexies, only the caudal block significantly prolonged the time to the first rescue analgesic when compared with the control group (4.1 hours; 95% CI, 0.7-7.5). Wound infiltration and landmark-based ilioinguinal-iliohypogastric block had relatively poor analgesic effects than other regional analgesics. No serious adverse effects related to the regional analgesic techniques were reported in any of the included studies. CONCLUSIONS: The quadratus lumborum and transversus abdominis plane blocks had the longest time to the first rescue analgesic and the least rescue analgesic requirement for pediatric inguinal surgeries. Specifically, the quadratus lumborum block had the longest analgesic duration in inguinal hernia repair, and the caudal block was found to be the only regional analgesia that extended the time to the first rescue analgesic in pediatric orchidopexy. Most included randomized controlled trials had some concern or a high risk of bias, and future studies should focus on providing high-quality evidence to further clarify the analgesic effects of regional analgesia for pediatric inguinal surgeries. (Anesth Analg 2024;138:108-22) KEY POINTS• Question: Which type of regional analgesia has the longest analgesic duration in pediatric inguinal surgeries? • Findings: The quadratus lumborum block had the longest time to the first rescue analgesic in inguinal hernia repair, whereas the caudal block was the only regional analgesia that extended the time to the first rescue analgesic in pediatric orchidopexy. • Meaning: The quadratus lumborum block has the...

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“…Finally, 69 eligible RCTs were included for qualitative and quantitative analyses. 22–90 A PRISMA flow diagram of the evidence selection process is presented in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Anesthesia and Analgesiamentioning

confidence: 99%

See 1 more Smart Citation

Analgesic Effects of Regional Analgesic Techniques in Pediatric Inguinal Surgeries: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Hung

Bai

Tsai

et al. 2023

Anesthesia &Amp; Analgesia

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“…(1999) and Feldman & Covino (1988) also showed that in similar concentrations, ropivacaine produces motor block of lesser intensity and shorter duration than bupivacaine in dogs, making it a good choice when the aim is to induce analgesia without loss of motor function. In addition, Caetano et al. (2006) reported that the utilization of sacral peridural block in children, submitted to inguinal herniorrhaphy with 0.2% ropivacaine, promoted sensory block of longer duration than motor block, which is considered an advantage for use in children who are uncomfortable with immobility of the limbs.…”

Section: Discussionmentioning

confidence: 99%

Brachial plexus blockade in chickens with 0.75% ropivacaine

Cardozo

Almeida

Fiúza

et al. 2009

Veterinary Anaesthesia and Analgesia

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“…Its popularity in pediatric anesthesia is mainly due to its broad spectrum of indications, high success rates, and a relative low incidence of complications. In clinical practice, however, caudal blocks have essentially been confined to children not heavier than 30 kg . Few case series are available on caudal blockade in adolescents or even in children heavier than 30 kg .…”

Section: Introductionmentioning

confidence: 99%

Feasibility and pharmacokinetics of caudal blockade in children and adolescents with 30–50 kg of body weight

Keplinger

Marhofer

Klug

et al. 2016

Pediatric Anesthesia

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Comparação entre três técnicas regionais de analgesia pós-operatória em crianças com ropivacaína

Abstract: Ilioinguinal/iliohypogastric nerve block was superior to ISW, especially in the first two hours after the surgery. The three anesthetic techniques can be safely and effectively used to control postoperative pain in inguinal herniorrhaphy in children.

Cited by 6 publications

References 22 publications

Analgesic Effects of Regional Analgesic Techniques in Pediatric Inguinal Surgeries: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Analgesic Effects of Regional Analgesic Techniques in Pediatric Inguinal Surgeries: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials

Brachial plexus blockade in chickens with 0.75% ropivacaine

Feasibility and pharmacokinetics of caudal blockade in children and adolescents with 30–50 kg of body weight

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