Efficacy of different analgesia treatments for abdominal surgery: A network meta-analysis.

Abstract

OBJECTIVE:

This study was designed to evaluate the efficacy of analgesia and incidence of postoperative nausea and vomiting (PONV) of several widely used clinical treatments for postoperative analgesia following abdominal surgery through network meta-analysis (NMA) based on published randomized controlled trials (RCTs).

METHODS:

This NMA was registered on PROSPERO as CRD 42020169606. Primary outcomes were pain scores (visual analog scale) and accumulative opioid consumption, and secondary outcomes assessed the incidence of PONV at 24 h after surgery.

RESULTS:

A total of 215 RCTs and 15,114 patients were identified in this NMA. In comparison with placebo, use of a preoperative paravertebral block (mean: -12.63, 95% CI: -21.12 to -4.13), continuous wound infiltration (mean: -9.68, 95%CI: -13.15 to -6.22) and postoperative wound infiltration (mean: -6.34, 95%CI: -10.59 to -2.08) had significantly lower pain scores, less opioid consumption (mean: -2.00, 95%CI: -3.52 to -0.48; mean: -1.34, 95%CI: -1.87 to -0.81; mean: -1.41, 95%CI: -2.07 to -0.74, respectively) and lower incidence of PONV (OR: 0.30, 95%CI: 0.13 to 0.67; OR: 0.49, 95%CI: 0.24 to 0.98; OR: 0.55, 95%CI: 0.34 to 0.89, respectively).

CONCLUSIONS:

The findings from our work provide evidence that preoperative paravertebral block was superior to continuous or postoperative wound infiltration to provide postoperative analgesia, nausea and vomiting after abdominal surgery.

• Authors: Chengluan Xuan, Wen Yan, Dan Wang, Cong Li, Haichun Ma, Ariel Mueller, Hao Deng, Timothy Houle, Jingping Wang
• Journal: European journal of pain (London, England) (Eur J Pain) Vol. 26 Issue 3 Pg. 567-577 (03 2022) ISSN: 1532-2149 [Electronic] England
• PMID: 34698423 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
• Copyright: © 2021 European Pain Federation - EFIC ®.

Chemical References

• Analgesics, Opioid

Topics

• Analgesia
• Analgesics, Opioid (therapeutic use)
• Humans
• Nerve Block
• Network Meta-Analysis
• Pain, Postoperative (etiology)
• Postoperative Nausea and Vomiting (complications, drug therapy, epidemiology)
• Randomized Controlled Trials as Topic