Articles: nerve-block.
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Paediatric anaesthesia · Jan 2025
Review Meta Analysis Comparative StudyErector spinae plane block versus intravenous opioid for analgesia in pediatric cardiac surgery: A systematic review and meta-analysis.
The erector spinae plane block (ESPB) has recently emerged as a regional anesthesia technique for perioperative pain management in pediatric cardiac surgery. However, evidence comparing its effectiveness with intravenous (IV) opioid-based analgesia is limited. We aimed to evaluate and compare the analgesic efficacy of ESPB versus IV opioids in this setting. ⋯ CRD 42024526961.
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Acta Anaesthesiol Scand · Jan 2025
Review Meta AnalysisAnterior quadratus lumborum blocks for postoperative pain treatment following intra-abdominal surgery: A systematic review with meta-analyses and trial sequential analyses.
The anterior quadratus lumborum (QL) block may be used for postoperative pain management for intra-abdominal surgeries, but the evidence is uncertain. We aimed to investigate the benefit and harm of the anterior QL block compared to placebo/no block for intra-abdominal surgery. ⋯ The anterior QL block may reduce cumulative 24-h opioid consumption. Reported serious adverse events were few and the anterior QL block may have little to no effect on the number of SAEs, but the evidence was very uncertain.
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J Coll Physicians Surg Pak · Jan 2025
Meta AnalysisPeripheral Nerve Block Combined with Low-Dose General Anaesthesia in Elderly Patients Receiving Hip Arthroplasty.
The study assessed the effectiveness and safety of nerve block combined with low-dose general anaesthesia in elderly hip arthroplasty patients, conducted by a meta-analysis of RCTs. Six trials involving 403 patients were identified from databases such as Cochrane, MEDLINE, and PubMed. The results demonstrated a statistically significant difference in pain scores at postoperative 12hours (95% CI, -2.39 to -0.35, p = 0.008) and 24hours (95% CI, -1.86 to -0.50, p = 0.0007). ⋯ However, between the two groups, there was no statistically significant difference in the 48hour pain score (95% CI, -2.58 to 0.62, p = 0.23). Essentially, this approach effectively reduces early post-surgical pain and it minimises anaesthetic use, whilst simultaneously lowering the risk of complications. Key Words: Nerve block, Elderly patients, Hip arthroplasty, Pain, Postoperative complication.
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Both superficial and deep serratus anterior plane (SAP) blocks are effective for anterior chest wall surgeries, but there is little clarity on which is more effective. Hence, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the comparative efficacy of the 2 approaches for SAP block after anterior chest wall surgery. ⋯ Current evidence does not support the preference for one approach of SAP block over the other for postoperative pain. Based on the available data, we recommend further future trials to determine any differences between these interventions.
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Review Meta Analysis
Rebound pain prevention after peripheral nerve block: A network meta-analysis comparing intravenous, perineural dexamethasone, and control.
Peripheral nerve blocks (PNBs) are widely used for postoperative analgesia, but rebound pain following block resolution poses a significant clinical challenge. Dexamethasone, administered either intravenously (IV) or perineurally, has shown promise in reducing rebound pain incidence, but the optimal route remains unclear. This network meta-analysis (NMA) aims to compare the effectiveness of different routes of dexamethasone administration, including IV, perineural, and control, in reducing the incidence of rebound pain following PNBs. ⋯ PROSPERO CRD42024530943.