Abstract | BACKGROUND: METHODS: Studies investigating analgesic effects of GONB against PDPH in adults were retrieved from the MEDLINE, EMBASE, Google scholar, and Cochrane central databases from their inception dates to May, 2021. Pain score at postprocedural 24 hours was the primary endpoint, while secondary endpoints were pain score at postprocedural 1 hour and 12 hours as well as the risk of intervention failure. RESULTS: Of the 7 studies (randomized controlled trials [RCTs], n = 4; non-RCTs, n = 3) that recruited 275 patients, 2 investigated female patients undergoing cesarean section and the other 5 were conducted in both obstetric and nonobstetric settings. Pooled results showed a lower mean pain score at 24 hours (i.e., primary outcome) (mean difference [MD] = -2.66, 95%: CI: -3.98 to -1.33, P < .001; I2 = 97%, 6 studies), 1 hour (MD = -4.23, 95% confidence interval [CI]: -5.08 to -3.37, P < .00001; I2 = 86%, 5 studies), and 6 hours (MD = -2.78, 95% CI: -4.99 to -0.57, P = .01; I2 = 98%, 4 studies) in patients with GONB compared to those without. Trial sequential analysis supported the robustness of evidence at postprocedural 24 hours. The use of GONB also decreased the risk of intervention failure (relative ratio [RR] = 0.4, 95% CI: 0.19 to 0.82, P = .01; I2 = 96%, 6 studies, 277 patients). CONCLUSION:
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Authors | Ying-Jen Chang, Kuo-Chuan Hung, I-Wen Chen, Chi-Lin Kuo, I-Chia Teng, Ming-Chung Lin, Ming Yew, Shu-Wei Liao, Chung-Yi Wu, Chia-Hung Yu, Kuo-Mao Lan, Cheuk-Kwan Sun |
Journal | Medicine
(Medicine (Baltimore))
Vol. 100
Issue 51
Pg. e28438
(Dec 23 2021)
ISSN: 1536-5964 [Electronic] United States |
PMID | 34941197
(Publication Type: Journal Article, Meta-Analysis)
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Copyright | Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. |
Chemical References |
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Topics |
- Adult
- Analgesia, Epidural
(adverse effects)
- Analgesia, Obstetrical
(adverse effects)
- Anesthesia, Conduction
- Anesthetics, Local
(administration & dosage)
- Female
- Humans
- Nerve Block
(methods)
- Pain
- Peripheral Nerves
(drug effects)
- Post-Dural Puncture Headache
(etiology, therapy)
- Pregnancy
- Treatment Outcome
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