Superior Hypogastric Plexus Block for Pain Management Post-Hysterectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Abstract

We aimed to evaluate the efficacy of superior hypogastric plexus (SHP) block in pain relief among women undergoing hysterectomy. Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021 for the available randomized clinical trials (RCTs). We included RCTs that compared SHP block (intervention group) to saline (control group) in hysterectomy. Our primary outcomes were pain scores at different time intervals using the Visual Analog Scale (VAS). Our secondary outcomes were postoperative opioid consumption within 24 hours and postoperative nausea and vomiting incidence. We extracted the available data from included studies and pooled them in a meta-analysis model using RevMan software. Four RCTs with a total number of 289 patients met our inclusion criteria. The VAS pain scores were significantly declined at post-anesthesia care unit (PACU), 2, 6, and 12 hours postoperatively among SHP block group (p < 0.05). However, no significant difference was reported in VAS pain score 1 day postoperatively between intervention and control groups. Moreover, SHP block significantly reduced the postoperative opioid consumption and incidence of nausea and vomiting (p = 0.03 & p = 0.003). In conclusion, superior hypogastric plexus block effectively reduces postoperative pain, opioid consumption, and incidence of nausea and vomiting post-hysterectomy.

• Authors: Ahmed Abdelaziz Abdelaziz Shama, Ahmed Mahmoud M M Elgarhy, Tamer M A Ewieda, Wael Mohamed Elmahdi Ibrahim, Mahmoud M Elsayed, Mohamed Hassan Arafa, Othman Saad-Eldeen Yahia, Abdelkarem Hussiny Ismail Elsayed, Doaa Mohamed Almonayery, Ahmed Mohamed Abdelhakim, Mohamed Kilany Ali Abdelsalam, Ahmed M Abbas, Mohammad Sunoqrot, Ahmed Goda Ahmed
• Journal: Journal of pain & palliative care pharmacotherapy (J Pain Palliat Care Pharmacother) Vol. 36 Issue 4 Pg. 233-241 (Dec 2022) ISSN: 1536-0539 [Electronic] England
• PMID: 35939039 (Publication Type: Meta-Analysis, Systematic Review, Journal Article)

Chemical References

• Analgesics, Opioid

Topics

• Female
• Humans
• Pain Management
• Analgesics, Opioid (therapeutic use)
• Hypogastric Plexus
• Randomized Controlled Trials as Topic
• Pain, Postoperative (drug therapy, etiology)
• Postoperative Nausea and Vomiting (epidemiology, prevention & control)
• Hysterectomy (adverse effects)