Evaluation of laparoscopic-guided rectus sheath block in gynecologic laparoscopy: A prospective, double-blind randomized trial

Kinjo, Yasuyuki; Kurita, Tomoko; Fujino, Yoshihisa; Kawasaki, Takashi; Yoshino, Kiyoshi; Hachisuga, Toru

doi:10.1016/j.ijsu.2019.01.004

Cited by 8 publications

(7 citation statements)

References 21 publications

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“…[ 5 25 26 27 28 29 30 31 32 33 34 35 36 39 40 41 43 ] Heterogeneity was found to be considerable (I 2 = 94%, Cochrane Q statistic P < 0.001). At the 10-12 h endpoint, RSB was again deemed effective in minimising postoperative pain scores (SMD -1.02, 95% CI [-1.51, -0.52], P <0.001),[ 25 26 30 31 32 33 34 36 37 38 41 42 ] with heterogeneity again being considerable (I 2 = 95%, Cochrane Q statistic P < 0.001). Finally, in the 12-24 h postoperative period, RSB was found insignificant compared to control at reducing postoperative pain scores (SMD -0.25, 95% CI [-0.55, 0.06], P = 0.11, I 2 = 83%).…”

Section: Resultsmentioning

confidence: 99%

“…A final total of 20 RCTs satisfied our inclusion criteria and were included in this analysis [ Table 1 ]. [ 5 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 ] The risk-of-bias analysis for all included studies is summarised in Figure 2 . Details on the evidence review for the primary and secondary outcomes can be found in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

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Investigation into the clinical performance of rectus sheath block in reducing postoperative pain following surgical intervention: A systematic review and meta-analysis of randomised controlled trials

Jeffries,

Harutyunyan,

Morse

et al. 2024

Indian Journal of Anaesthesia

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Background and Aims: Rectus sheath block (RSB) is an effective postoperative pain control technique in abdominal surgical procedures. This systematic review evaluated the efficacy and outcome data of patients undergoing RSB compared to the standard of care in both laparoscopic and open surgical procedures. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO ID: CRD42022372596). The search was restricted to randomised controlled trials (RCTs) comparing RSB effectiveness on postoperative pain to any standard general anaesthesia technique (control). We systematically explored PubMed, Medline, Central, Scopus and Web of Science for RCTs from inception to September 2023. The primary outcome was the evaluation of pain scores at rest 0-2, 10-12 and 12-24 h postoperatively. The secondary outcome was the analysis of postoperative intravenous (IV) morphine equivalent consumption at 24-h. A risk-of-bias tool for randomised trials (ROB 2.0, Cochrane, Copenhagen, Denmark) assessment and Grades of Recommendation, Assessment, Development and Evaluation (GRADE, Cochrane, Copenhagen, Denmark) analysis was conducted to evaluate the quality of the RCTs. Results: Twenty RCTs involving 708 participants who received RSB intervention and 713 who received alternative analgesic care were included. RSB pain scores were significantly lower than control at 0-2 h (P < 0.001) and 10-12 h (P < 0.001) postoperatively. No significant effect was observed at 24 h (P = 0.11). RSB performance compared to control in 24-h IV morphine equivalency in milligrams was significantly lower (P < 0.001). Conclusion: RSB implementation was associated with reduced postoperative pain scores and decreased opioid consumption in IV morphine equivalency up to 24 h following surgical intervention.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Investigation into the clinical performance of rectus sheath block in reducing postoperative pain following surgical intervention: A systematic review and meta-analysis of randomised controlled trials

Jeffries,

Harutyunyan,

Morse

et al. 2024

Indian Journal of Anaesthesia

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“…Maloney et al found that RSB leads to decreased opioid consumption and that patients who had RSB had lower pain scores compared to local infiltration analgesia in pediatric single incision laparoscopic surgery [ 17 ]. However, Kinjo et al found no difference in the reduction of postoperative pain in RSB compared to the control group in gynecologic laparoscopy [ 9 ]. TAPB is also widely used for analgesia during and after abdominal surgery [ 14 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that the transverse abdominal plane block (TAPB) or rectus sheath block (RSB) can significantly reduce the use of intraoperative and postoperative analgesics and reduce postoperative pain scores in patients with abdominal median incision surgery [ 4 , 5 , 6 , 7 , 8 ]. However, some controversial research has found that there were no differences, and that the effects were not obvious compared to the control group [ 9 , 10 ]. The reasons for these inconsistent results may be the inconsistent dosage or concentration of the drugs used.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the multiple and dispersed incisions in laparoscopic surgery may also be a contributing factor. Therefore, using only bilateral TAPB or RSB may make it difficult to effectively block incision pain [ 9 , 10 ]. However, an incision-based rectus sheath block (IBRSB) may be able to achieve the dual effect of nerve block and local invasiveness, because the block sites are closer to the surgical incision than TAPB or RSB alone.…”

Section: Introductionmentioning

confidence: 99%

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Opioid-Sparing Effect of Multi-Point Incision-Based Rectus Sheath Block in Laparoscopic-Assisted Radical Gastrectomy: A Randomized Clinical Trial

Shi

Zhou

Wang

et al. 2023

JCM

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Background: Profound trauma from laparoscopic-assisted gastrectomy (LAG) requires medication with a large number of opioids. The purpose of our study was to observe whether an incision-based rectus sheath block (IBRSB) based on the locations of the surgical incision could significantly reduce the consumption of remifentanil during LAG. Methods: A total of 76 patients were included. The patients were prospectively randomized into two groups. Patients in group IBRSB (n = 38) received ultrasound-guided IBRSB, and the patients received 0.4% ropivacaine 40–50 mL. Patients in group C (n = 38) received the same IBRSB with 40–50 mL normal saline. The following were recorded: the consumption of remifentanil and sufentanil during surgery, pain scores at rest and during conscious activity in the post-anesthesia care unit (PACU) and at 6, 12, 24, and 48 h after surgery, and use of the patient-controlled analgesia (PCA) at 24 and 48 h after surgery. Results: A total of 60 participants completed the trial. The consumption of remifentanil and sufentanil in group IBRSB were significantly lower than that in group C (p < 0.001). Pain scores at rest and during conscious activity in the PACU and at 6, 12, 24, and 48 h after surgery and patients’ PCA consumption within 48 h of surgery were significantly lower in group IBRSB than in group C (all p < 0.05). Conclusions: IBRSB based on incision multimodal anesthesia can effectively reduce the consumption of opioids during LAG, improving the postoperative analgesic effect and increasing patients’ satisfaction.

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Peripheral truncal blocks—Overview and assessment

et al. 2020

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Evaluation of laparoscopic-guided rectus sheath block in gynecologic laparoscopy: A prospective, double-blind randomized trial

Cited by 8 publications

References 21 publications

Investigation into the clinical performance of rectus sheath block in reducing postoperative pain following surgical intervention: A systematic review and meta-analysis of randomised controlled trials

Investigation into the clinical performance of rectus sheath block in reducing postoperative pain following surgical intervention: A systematic review and meta-analysis of randomised controlled trials

Opioid-Sparing Effect of Multi-Point Incision-Based Rectus Sheath Block in Laparoscopic-Assisted Radical Gastrectomy: A Randomized Clinical Trial

Peripheral truncal blocks—Overview and assessment

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