Superior Hypogastric Plexus Nerve Block in Minimally Invasive Gynecology: A Randomized Controlled Trial

Silva, Praveen De; Daniels, Sam; Bukhari, Mujahid; Choi, Sarah; Liew, A. C. S.; Rosen, David Michael Beck; Cario, Gregory M.; Chou, Danny

doi:10.1016/j.jmig.2021.06.017

Cited by 12 publications

(19 citation statements)

References 16 publications

(15 reference statements)

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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%

“…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 ) . The SHP block was performed at the start of MIH in one study ( 9 ) and at the end of the MIH in two studies ( 8 , 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: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 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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Paragastric Autonomic Neural Blockade to Prevent Early Visceral Pain and Associated Symptoms After Laparoscopic Sleeve Gastrectomy: a Randomized Clinical Trial

Daes¹,

Morrell

Hanssen

et al. 2022

OBES SURG

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Background Visceral pain (VP) following laparoscopic sleeve gastrectomy remains a substantial problem. VP is associated with autonomic symptoms, especially nausea and vomiting, and is unresponsive to traditional pain management algorithms aimed at alleviating somatic (incisional) pain. The present study was performed to evaluate the safety and effectiveness of laparoscopic paragastric autonomic neural blockade (PG-ANB) in managing the symptoms associated with VP following sleeve gastrectomy. Study Design This prospective, double-blinded, randomized clinical trial involved patients undergoing laparoscopic sleeve gastrectomy at two high-volume institutions. The patients were randomized to laparoscopic transversus abdominis plane block with or without PG-ANB. The primary outcome was patient-reported pain scores assessed at 1, 8, and 24 h postoperatively. The secondary outcome measures were analgesic requirements, nausea, vomiting, hiccups, and hemodynamic changes immediately after PG-ANB and postoperatively. Results In total, 145 patients (block group, n = 72; control group, n = 73) were included in the study. The heart rate and mean arterial pressure significantly decreased 10 min after PG-ANB. The visual analog scale score for pain was significantly lower in the PG-ANB than in the control group at 1 h postoperatively (p < 0.001) and 8 h postoperatively (p < 0.001). Vomiting, nausea, sialorrhea, and hiccups were significantly less prevalent in the PG-ANB group. Patients in the PG-ANB group received fewer cumulative doses of analgesics at 1 h postoperatively (p = 0.003) and 8 h postoperatively (p < 0.001). No differences between the groups were detected at 24 h (p = 0.298). No complications related to PG-ANB occurred. Conclusion PG-ANB safely and effectively reduces early VP, associated autonomic symptoms, and analgesic requirements after laparoscopic sleeve gastrectomy. Graphical abstract

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A comparative retrospective analysis on robot-assisted laparoscopic surgery compared to conventional laparoscopy in case of myomectomy: experience in a third-level hospital of Southern Italy

Della Corte,

D’Angelo,

Ascione

et al. 2024

Updates Surg

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Uterine myomas are the most common gynecological disease in reproductive-aged women, present several symptoms, and require effective medical and/or surgical strategies. This study aimed to compare robotic-assisted laparoscopic myomectomy (RALM) with laparoscopic myomectomy (LM) in terms of operative times, intraoperative estimated blood loss, pre- and post-hemoglobin levels drop, and length of hospital stay. Data from 50 clinical records (25 RALM in Group A and 25 LM in Group B) of patients with uterine fibroids were collected from December 2022 to December 2023 at Gynecological Unit of DAI Materno-Infantile Federico II in Naples, Italy. Patients aged 30–49 years with symptomatic fibroids were included. Data on peri-operative outcomes, including operative time for myomectomy (OTM), overall operative time (OOT), intraoperative estimated blood loss (EBL), pre- and post-operative hemoglobin levels, and length of hospital stay were analyzed. The OTM in the presence of > 5 myomas was 59 [52–65] vs 69 min [61–96] (p < 0.001) for RALM and LM groups, respectively. Moreover, also in presence of ≤ 5 myomas, a difference was observed in the RALM group 48[43–55] compared to the LM group 53[50–61] min (p = 0.07). The OOT was also statistically significant for Group A compared to Group B (83[65–93] vs 72[56–110] min, p < 0.001). There were no significant differences between the two groups in terms of pre- and post-operative hemoglobin levels and EBL (p = 0.178). Group A demonstrated a notably shorter hospital stay 1.2 [1–2] days compared to Group B 2.9[3–3.75] days (p = 0.007). Our study suggests potential advantages of RALM over LM in terms of reduced operative times and shorter hospital stays. The standardized approach and extensive surgical experience likely contributed to the favorable outcomes of RALM.

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Superior Hypogastric Plexus Nerve Block in Minimally Invasive Gynecology: A Randomized Controlled Trial

Cited by 12 publications

References 16 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

Paragastric Autonomic Neural Blockade to Prevent Early Visceral Pain and Associated Symptoms After Laparoscopic Sleeve Gastrectomy: a Randomized Clinical Trial

A comparative retrospective analysis on robot-assisted laparoscopic surgery compared to conventional laparoscopy in case of myomectomy: experience in a third-level hospital of Southern Italy

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