Most effective pain‐control procedure for open liver surgery: a network meta‐analysis

Zhou, Ling; Huang, Jian; Chen, Changwang

doi:10.1111/ans.14456

Cited by 2 publications

(2 citation statements)

References 41 publications

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“…Many perioperative strategies have been evaluated in this group of patients but there is still no consensus on the best practice [9,10]. Commonly used modalities for postoperative pain control are systemic intravenous analgesics, epidural analgesia, and peripheral nerve blocks [11,12]. Systemic intravenous administration of analgesics (as opioids and non-steroidal anti-inflammatory drugs) is effective but associated with potentially harmful side effects, such as respiratory depression, nausea and vomiting, pruritus, gastrointestinal bleeding, and renal failure [13,14].…”

Section: Introductionmentioning

confidence: 99%

Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence

Dudek

Zawadka

Andruszkiewicz

et al. 2021

JCM

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Background: The existing recommendations for after open liver surgery, published in 2019, contains limited evidence on the use of regional analgesia techniques. The aim of this systematic review is to summarize available clinical evidence, published after September 2013, on systemic or blended postoperative analgesia for the prevention or treatment of postoperative pain after open liver surgery. Methods: The PUBMED and EMBASE registries were used for the literature search to identify suitable studies. Keywords for the literature search were selected, with the authors’ agreement, using the PICOS approach: participants, interventions, comparisons, outcomes, and study design. Results: The literature search led to the retrieval of a total of 800 studies. A total of 36 studies including 25 RCTs, 5 prospective observational, and 7 retrospective observational studies were selected as suitable for this systematic review. Conclusions: The current evidence suggests that, in these patients, optimal postoperative pain management should rely on using a “blended approach” which includes the use of systemic opioids and the infusion of NSAIDs along with regional techniques. This approach warrants the highest efficacy in terms of pain prevention, including the lower incretion of postoperative “stress hormones”, and fewer side effects. Furthermore, concerns about the potential for the increased risk of wound infection related to the use of regional techniques have been ruled out.

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Section: Introductionmentioning

confidence: 99%

Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence

Dudek

Zawadka

Andruszkiewicz

et al. 2021

JCM

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show abstract

“…4 Intravenous analgesia, epidural analgesia, and peripheral nerve blocks are common postoperative analgesia modalities in clinical practice. [7][8][9] Systemic intravenous analgesia could contribute to side effects including respiratory depression, nausea, vomiting, and pruritus. 10,11 Whereas sympathetic blockade (hypotension, bradycardia) or patient coagulation dysfunction limits its use, epidural analgesia may provide better pain management.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Ultrasound-Guided Continuous Low Serratus Anterior Plane Block for Pain Management After Hepatectomy: A Randomized Controlled Trial

Jiang¹,

Wu²,

Liu³

et al. 2023

JPR

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Adequate postoperative analgesia is a key to earlier recovery from open surgery. This work investigated the pain control and quality of patient recovery after hepatectomy to evaluate the modified continuous serratus anterior plane block (called low SAPB) for postoperative analgesia. Patients and Methods: This single-center, blinded, randomized, controlled study included 136 patients who underwent hepatectomy under general anesthesia. For postoperative analgesia, the patients in the SAPB group were given a continuous low SAPB at the 7th intercostal space in the right mid-axillary line, and the patients in the control group were given continuous intravenous opioid analgesia. The numeric pain rating scale (NPRS) was used for pain assessment. The postoperative assessment focused on the remedial drug consumption, the occurrence of adverse postoperative analgesic reactions, and the quality of patient recovery evaluated with the QoR-15 questionnaire. Results: Compared to the controls, the SAPB patients had significantly lower NPRS scores at 12 h and 24 h at rest and 6 h, 12 h, and 24 h in motion, and a longer time to first use of remedial analgesics at 24 h, and higher overall QoR-15 scores at 24 h [124 (121, 126) vs 121 (120, 124)] and 48 h [129 (126, 147) vs 126 (125, 128)], after surgery. There was no significant difference in the incidence of analgesia-related adverse reactions between the two groups. Conclusion:The continuous low SAPB could achieve superior pain control, especially for motor pain, to intravenous opioid analgesia during the first 24 h post-surgery. Even with no significant difference in the incidence of postoperative adverse reactions, patients with continuous low SAPB appeared to have a higher quality of recovery in the first two days post-surgery than patients with continuous intravenous analgesia.

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Most effective pain‐control procedure for open liver surgery: a network meta‐analysis

Cited by 2 publications

References 41 publications

Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence

Postoperative Analgesia after Open Liver Surgery: Systematic Review of Clinical Evidence

Assessment of Ultrasound-Guided Continuous Low Serratus Anterior Plane Block for Pain Management After Hepatectomy: A Randomized Controlled Trial

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