Superior Hypogastric Plexus Block to Reduce Pain After Laparoscopic Hysterectomy

Clark, Nisse V.; Moore, Kristin J.; Maghsoudlou, Parmida; North, Alexandra; Ajao, Mobolaji O.; Einarsson, Jon I.; Louie, Michelle; Schiff, Lauren; Moawad, Gaby; Cohen, Sarah L.; Carey, Erin T.

doi:10.1097/aog.0000000000004329

Cited by 8 publications

(20 citation statements)

References 19 publications

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“…The remaining seven citations were subjected to full-text reading, of which four citations were excluded with reasons: abstract (n=2), study with “unknown” status on Clinicaltrials.gov (n=1), and study with “recruiting” status on World Health Organization International Clinical Trials Registry Platform [WHO ICTRP] (n=1). Finally, three studies, comprising 210 patients (SHP=107 and non-SHP=103) were included in this systematic review ( 8 , 9 , 10 ) . These studies were published during 2019-2022 and conducted in Turkey (n=1) ( 8 ) , United States of America (n=1) ( 9 ) , and Australia (n=1) ( 10 ) .…”

Section: Resultsmentioning

confidence: 99%

“…Finally, three studies, comprising 210 patients (SHP=107 and non-SHP=103) were included in this systematic review ( 8 , 9 , 10 ) . These studies were published during 2019-2022 and conducted in Turkey (n=1) ( 8 ) , United States of America (n=1) ( 9 ) , and Australia (n=1) ( 10 ) . One study was a nonrandomized comparative trial (i.e., cohort study) ( 8 ) whereas the remaining two studies were RCTs ( 9 , 10 ) .…”

Section: Resultsmentioning

confidence: 99%

“…These studies were published during 2019-2022 and conducted in Turkey (n=1) ( 8 ) , United States of America (n=1) ( 9 ) , and Australia (n=1) ( 10 ) . One study was a nonrandomized comparative trial (i.e., cohort study) ( 8 ) whereas the remaining two studies were RCTs ( 9 , 10 ) . The routes of MIH were laparoscopic in two studies ( 8 , 9 ) and mixed laparoscopic/robotic in one study ( 10 ) .…”

Section: Resultsmentioning

confidence: 99%

“…Few studies have examined the efficacy of SHP block on reducing postoperative pain and opioid consumption among patients undergoing MIH ( 8 , 9 , 10 ) . However, the results have been limited by the small sample size of participants, contradictory findings, and different study designs.…”

Section: Introductionmentioning

confidence: 99%

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Superior hypogastric plexus (SHP) block during minimally invasive hysterectomy: A systematic review

Alomar¹,

Abuzaid²,

Abu‐Zaid³

et al. 2022

tjod

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To systematically summarize the efficacy and safety of superior hypogastric plexus (SHP) block versus no SHP block among patients undergoing minimally invasive hysterectomy (MIH). Five information sources were screened from inception until 04.04.2022 and comprised the Cochrane Central Register of Controlled Trials, PubMed, Embase, Scopus, and Web of Science. The inclusion criteria comprised (i) patients: individuals undergoing MIH, (ii) intervention: SHP block, (iii) Comparator: no SHP block, (iv) Outcomes: postoperative pain, postoperative opioid consumption, operation time, estimated intraoperative blood loss, hospital stay, and complications/toxicities, and (v) Study design: randomized controlled trials (RCTs) and non-randomized comparative trials published in peer-reviewed journals. Owing to the insignificant number of available studies, methodologic heterogeneity, and procedural variances, it was impossible to carry out a quantitative meta-analysis. Hence, the results of the included studies were only reported qualitatively (descriptively). Three studies (2 RCTs and 1 cohort study), comprising 210 patients (SHP=107 and non-SHP=103) were included in the qualitative synthesis. Overall, the included studies had a low risk of bias. The results showed that SHP block appeared largely safe and could reduce postoperative pain and opioid consumption. However, SHP block did not offer clinical benefits in terms of reduced operation time, intraoperative blood loss, and hospital stay compared with non-SHP block. Among patients undergoing MIH, this first ever systematic review showed that SHP block was safe and exhibited potential analgesic and opioid-sparing effects postoperatively. Additional RCTs are needed to carry out a powered meta-analysis and validate the findings.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Superior hypogastric plexus (SHP) block during minimally invasive hysterectomy: A systematic review

Alomar¹,

Abuzaid²,

Abu‐Zaid³

et al. 2022

tjod

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“… 4 Laparoscopic surgery has the advantages of thorough exploration and small surgical wounds. However, surgical incisions, CO 2 pneumoperitoneum, and remifentanil-induced hyperalgesia (RIH) can lead to pain and agitation during the awakening period, 5 , 6 which not only makes anesthesia management more difficult but also renders patients susceptible to unintentional injury. 7 Studies have shown that patients treated with gynecological laparoscopy are up to 80% more likely to experience post-procedural pain.…”

Section: Introductionmentioning

confidence: 99%

A Dose-Response Relationship Study of Prophylactic Nalbuphine to Reduce Pain During the Awakening Period in Patients Undergoing Laparoscopic Total Hysterectomy: A Randomized, Controlled, Double-Blind Clinical Study

Wang¹,

Wang²,

Zuo³

et al. 2022

DDDT

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Purpose Prophylactic intravenous nalbuphine was administered to observe its median effective dose (ED 50 ) in reducing pain after undergoing laparoscopic total hysterectomy. To investigate the effect of different doses of nalbuphine on postoperative analgesia and adverse reactions in patients. Patients and Methods The 120 patients undergoing laparoscopic total hysterectomy were divided into 6 groups: group C (control) and group P (5 different doses of nalbuphine) with 20 patients per group. The doses of nalbuphine in group P were in an equally proportional series (groups P1, P2, P3, P4, and P5 received doses of 0.280, 0.200, 0.140, 0.100, and 0.070 mg/kg, respectively), diluted to 20 mL with saline and administered 5 min before the induction of anesthesia. A similar volume (20 mL) of saline was administered to group C 5 min before the induction of anesthesia. The numeric rating scale (NRS) of patients during awakening and after surgery, the number of postoperative salvage analgesia, and the occurrence of postoperative adverse effects were recorded. Results The ED 50 (95% confidence interval (CI)) of nalbuphine in preventing pain during the awakening period in patients calculated using the point-slope method was 0.125 (0.108, 0.145) mg/kg. NRS scores differed among the 6 groups at 30 min and 1 h after extubation ( P < 0.001; P < 0.001). Pairwise comparisons between groups revealed that, at 30 min after extubation, compared with group P1, the NRS scores of groups P4, P5, and C were higher ( P = 0.001, P < 0.001, P < 0.001); compared with group P2, groups P5 and C had higher NRS scores ( P = 0.011, P = 0.001). At 1 h after extubation, the NRS scores of groups P1 and P2 were lower than that of group P4 ( P = 0.046, P = 0.036). Compared with the control, only the group P1 had a lower cough score ( P = 0.009) and there were no differences in the other groups. There were no differences in sedation score at 10 min after extubation, the incidence of adverse events at 24 h postoperatively, or the number of remedial analgesics at 24 h postoperatively ( P > 0.05). Conclusion The ED 50 (95% CI) of nalbuphine as a prophylactic in reducing pain during recovery was 0.125 (0.108, 0.145) mg/kg. Compared with the control, nalbuphine at doses of 0.140, 0.200, and 0.280 mg/kg prevented pain during the awakening period. Among these doses, 0.280 mg/kg was determined to be the best, the occurrence of cough was less during extubation and the postoperative analgesic effect was good. However, it is necessary to pay attention to the occurrence of adverse reactions. ...

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Safety and efficacy of ultrasound-guided superior hypogastric plexus block combined with conscious sedation in ambulatory patients undergoing percutaneous microwave ablation of uterine myomas: Study protocol for a single-center, double-blinded, randomized controlled trial

Yan,

Wang,

Zhang

et al. 2024

Heliyon

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Superior Hypogastric Plexus Block to Reduce Pain After Laparoscopic Hysterectomy

Abstract: Personal or nonessential information may be redacted at the editor's discretion.

Cited by 8 publications

References 19 publications

Superior hypogastric plexus (SHP) block during minimally invasive hysterectomy: A systematic review

Superior hypogastric plexus (SHP) block during minimally invasive hysterectomy: A systematic review

A Dose-Response Relationship Study of Prophylactic Nalbuphine to Reduce Pain During the Awakening Period in Patients Undergoing Laparoscopic Total Hysterectomy: A Randomized, Controlled, Double-Blind Clinical Study

Safety and efficacy of ultrasound-guided superior hypogastric plexus block combined with conscious sedation in ambulatory patients undergoing percutaneous microwave ablation of uterine myomas: Study protocol for a single-center, double-blinded, randomized controlled trial

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