scholarly journals Analgesic effectiveness of quadratus lumborum block for patients after abdominal surgery: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Tianyu Liu ◽  
Chao Xu ◽  
He Zhu ◽  
Xiuxiu Gao ◽  
Lulu Guo ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Cesarean Section ◽  
Abdominal Surgery ◽  
Meta Analysis ◽  
Opioid Consumption ◽  
Cochrane Library ◽  
Control Group ◽  
Vas Score ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum

Abstract Background: A series of studies have reported that quadratus lumborum block (QLB) can have a great postoperative analgesia for lower abdominal surgery. However, a meta-analysis of the analgesic effect of QLB in patients undergoing lower abdominal surgery has not been published.Methods： We searched the databases of Pubmed, Embase, Cochrane Library, and Web of Science (updated to October 15, 2019). We cumulative opioid consumption at 6, 12, 24 and 48h after surgery; pain score (rest and dynamic) at 6, 12, 24 and 48h after surgery; occurrence of common opioid-related complications at 24h after surgery . Opioid consumption as the main outcome.Results：Thirteen randomized controlled trials (RCTs) including 751 patients were analysed. Compared with control group, QLB group can effectively reduce 24 and 48h cumulative opioid consumption 10.1mg (95%CI: -13,-7.2; p<0.00001) and 16.22mg (95%CI: -19.39,13.03; p<0.00001) in patients with cesarean section, but can reduce effectively cumulative opioid consumption in patients undergoing laparoscopic surgery at 6, 12 and 24h. Posterior QLB group and transmuscular QLB group reduced 24h cumulative opioid consumption 4.03mg ( 95%CI: -7.89, -0.19; p=0.04) and 12.44mg ( 95%CI: -20.2, -4.68; p=0.002), respectively. QLB group reduced rest visual analogue scale (VAS) score at 12 , 24 and 48 h ,however, the effective reduction of rest VAS score in patients undergoing cesarean section only occurs at 24h after surgery.Conclusion：QLB seems to provide better analgesia for patients undergoing laparoscopic surgery than patients undergoing cesarean section. Transmuscular QLB appears to have reduced postoperative opioid consumption compared to posterior QLB. More future RCTs are needed to support our conclusions.

Effects of abdominal binders on postoperative pain and functional recovery: a systematic review and meta-analysis

Pain Medicine ◽  
2021 ◽  
Author(s):  
Xin Sun ◽  
Qingchuan Wei ◽  
Chenying Fu ◽  
Qing Zhang ◽  
Zejun Liang ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Abdominal Surgery ◽  
Pulmonary Function ◽  
Physical Function ◽  
Functional Recovery ◽  
Meta Analysis ◽  
Forced Expiratory Volume ◽  
Cochrane Library ◽  
Control Group ◽  
Vas Score

Abstract Objective This study aimed to assess the effectiveness of abdominal binders (ABs) on postoperative pain and functional recovery in patients receiving abdominal surgery. Methods The Pubmed, Embase, Cochrane Library, and PEDro databases were searched for clinical trials published up to November 30, 2019. Randomized controlled trials that compared the effects of wearing an AB to not wearing an AB in participants after abdominal surgery were included. The primary outcomes were pain, pulmonary function, and physical function, as assessed by the visual analog scale (VAS) score, a spirometry device, and the 6-min walk test (6MWT), respectively. The registration number of this review in PROSPERO is CRD42020165303. Results Fourteen trials involving 1317 participants were included. Pooled estimates for the VAS score and the 6MWT showed significant differences between the AB group and the control group, especially on the fourth day following surgery (Mean Difference (MD) = -2.82, 95% Confidence Interval (CI) -3.41 to -2.22, P &lt; 0.00001; MD = 50.97 m, 95% CI 39.99 to 61.95 m, P &lt; 0.00001). However, no significant differences were found in pulmonary function (forced vital capacity (FVC): MD = 0.01, 95% CI -0.29 to -0.32, P = 0.94; forced expiratory volume during 1 s (FEV1): MD = -0.05; 95% CI -0.24 to 0.14; p = 0.63; FEV1/FVC: MD = 3.14, 95% CI -2.78 to 9.06, P = 0.30). Conclusion ABs probably improve postoperative pain and physical function, especially on the fourth day or more following abdominal surgery, but they have no effects on pulmonary function.

scholarly journals Impact of Ketamine on Pain Management in Cesarean Section: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2;23 (4;2) ◽  
pp. 135-148
Author(s):  
Zifeng Xu
Keyword(s):  
Cesarean Section ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Control Effect ◽  
Randomized Controlled ◽  
Time Required ◽  
The Cochrane Library

Background: The pain control effect of ketamine versus control in women during cesarean operation is not well determined. Objectives: The present meta-analysis aimed to evaluate the clinical efficacy of ketamine versus control in cesarean section anesthesia for reducing the postoperative pain and analgesia. Study Design: We used meta-analysis to address this concern. Setting: Meta-analysis-based study. Methods: The databases PubMed, Embase, and the Cochrane Library were systematically searched to identify the relevant randomized controlled trials (RCTs) of ketamine versus control in controlling pain after cesarean section from inception to August 2018. Based on the Cochrane Handbook, the combined analysis was performed using Revman 5.3 software. Results: A total of 20 RCTs with 1,737 patients who underwent cesarean section were included. Meta-analysis showed that the pain score in the ketamine group was less than that of the control group (mean difference [MD], –1.10; 95% confidence interval [CI], –1.61, –0.59; P < 0.0001). Application of ketamine during cesarean section also resulted in decreased consumption of morphine when compared with the control group (MD, –6.11 mg; 95% CI, –9.93, –2.29; P = 0.002). In addition, the first time required for analgesia was significantly longer in the ketamine group than that of the control group (MD, 72.48 minutes; 95% CI, 50.85, 94.11; P < 0.00001). Limitations: Limited patients were included with moderate strength. Conclusions: Ketamine supplementation during cesarean section reduces pain and morphine consumption and prolongs the postoperative analgesia. Key words: Ketamine, cesarean section, randomized controlled trials, meta-analysis

scholarly journals Role of platelet-rich plasma in the treatment of osteoarthritis: a meta-analysis

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096466
Author(s):  
Haijiang Ren ◽  
Shouwei Zhang ◽  
Xuejie Wang ◽  
Zehui Li ◽  
Wenlai Guo
Keyword(s):  
Patient Satisfaction ◽  
Clinical Efficacy ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Womac Score ◽  
Cochrane Library ◽  
Control Group ◽  
Absolute Value ◽  
Vas Score ◽  
The Absolute

Objective The clinical efficacy of platelet-rich plasma (PRP) in the treatment of osteoarthritis remains controversial. In this paper, we evaluated the clinical efficacy of PRP in the treatment of osteoarthritis using meta-analysis, providing evidence for the selection of clinical treatment options. Methods We performed a computer-based search of PubMed, Embase, and the Cochrane Library databases to retrieve articles using the search terms “platelet-rich plasma”, “osteoarthrosis”, and “knee joint”. Quality evaluation and data extraction were performed. The combined effect was assessed using RevMan 5.3 software. Results Five randomized controlled trials, involving 320 patients, were included in this study. No significant differences were observed in the International Knee Documentation Committee score, visual analog scale (VAS) score, or the absolute value of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score between the experimental and control groups. The absolute value of the VAS score and change in the WOMAC score were significantly decreased and patient satisfaction was increased in the experimental group, as compared with the control group. Conclusion The findings of this meta-analysis suggest that intra-articular injection of PRP is an effective treatment for osteoarthritis that can reduce post-operative pain, improve locomotor function, and increase patient satisfaction.

scholarly journals Comparative evaluation of intrathecal bupivacaine alone and bupivacaine combined with dexmedetomidine in cesarean section using spinal anesthesia: a meta-analysis

2019 ◽  
Vol 47 (7) ◽  
pp. 2785-2799 ◽  
Author(s):  
Xin Liu ◽  
Xiongjie Zhang ◽  
Xujian Wang ◽  
Jinyan Wang ◽  
Hao Wang
Keyword(s):  
Confidence Interval ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Outcome Measure ◽  
Meta Analysis ◽  
Sensory Block ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Control Group ◽  
Block Level

Objective This meta-analysis was performed to evaluate the effect of spinal anesthesia (SA) using bupivacaine combined with dexmedetomidine (DEX) in cesarean section, analyze the adverse drug reactions induced by this mixture, and provide a reference for rational drug use. Methods Randomized controlled trials were obtained from the PubMed, Cochrane Library, and Embase databases. The primary outcome measure was the time to the highest sensory block level (min), and the secondary outcome measure was adverse effects. Results The time to the highest sensory block level was significantly shorter in the bupivacaine-DEX group than in the control group (standardized mean difference, −0.23; 95% confidence interval, −0.43 to −0.03). The incidence of shivering during the process of anesthesia, especially at a dose of 5 µg DEX, was significantly lower in the bupivacaine-DEX group than in the control group (odds ratio, 0.26; 95% confidence interval, 0.14–0.49). No significant differences were observed in the symptoms of hypotension, bradycardia, nausea/vomiting, or pruritus. Conclusion Compared with the use of bupivacaine alone for SA in cesarean section, adding dexmedetomidine during SA can significantly shorten the onset time and decrease the rate of shivering during anesthesia.

scholarly journals Ultrasound-guided Quadratus Lumborum Block for Perioperative Analgesia in Robot-assisted Partial Nephrectomy: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Jielan Lai ◽  
Quehua Luo ◽  
Yanling Liu ◽  
Ruifeng Xue ◽  
Yang Huang ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Case Reports ◽  
Controlled Trial ◽  
Opioid Consumption ◽  
Control Group ◽  
Robot Assisted ◽  
Early Recovery ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum ◽  
Significant Difference

Abstract Background Recently, several case reports and limited randomized studies have shown that the quadratus lumborum block (QLB) is effective in providing pain relief after intra-abdominal and retroperitoneal operations. Robot-assisted partial nephrectomy (RAPN) has also been proposed as a promising operative treatment for renal carcinoma because it enables early recovery and ambulation. Therefore, we aimed to evaluate the analgesic and opioid-sparing effects of a single-injection QLB, which may paly an important role on early recovery program in RAPN.MethodsFifty-six patients undergoing elective RAPN under general anesthesia were randomised to two equally sized groups. Patients were randomly allocated to receive unilateral QLB (n=28) with 0.375% bupivacaine 0.5 mL/kg (QLB group) or a conventional scheme (n=28) group (Control group). The QLB technique was performed as first described by Blanco, termed QLB2. The primary outcome was the visual analogue scale (VAS) scores with movement at 6 hours postoperatively. The secondary endpoints were the morphine consumption at different time-period after surgery, morphine-related side effects and assessment of postoperative rehabilitation. ResultsBoth VAS pain score and cumulative opioid consumption were significantly lower in the QLB group at 6 hours after surgery as compared with the control group (all P<0.05). There was significant difference in pain scores at any other time-point except at 4 hours on movement and 48 hours at rest. However, no significant difference was observed in 12-48 hours cumulative opioid consumption, and in the duration of PACU and hospital stay between the two groups. The patient recovery scores was significantly higher in the QLB group.ConclusionsSingle-injection pre-emptive QLB applied to RAPN was effective and provided satisfactory analgesia and opioids-sparing in combination with a typical patient-controlled analgesia. In addition, it may provide an effective technique for early recovery in perioperative period.

scholarly journals Quadratus lumborum block for postoperative analgesia after cesarean section: a meta-analysis of randomized controlled trials with trial sequential analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zhigang Zhao ◽  
Kaiming Xu ◽  
Yanting Zhang ◽  
Gang Chen ◽  
Youfa Zhou
Keyword(s):  
Cesarean Section ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Analgesic Efficacy ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Sufficient Data ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
Quadratus Lumborum

AbstractThe aim of this study was to assess the analgesic efficacy of QLB versus controls in women undergoing cesarean section (CS). We systematically searched Cochrane Library, PUBMED, EMBASE, VIP, WANFANG, and China National Knowledge Infrastructure. Trials were eligible if parturients received QLB during CS. GRADE system was used to assess the certainty of evidence and Trial sequential analyses (TSA) were performed to determine whether the results are supported by sufficient data. Thirteen studies involving 1269 patients were included. Compared to controls, QLB significantly reduced the cumulative postoperative intravenous opioid consumption (in milligram morphine equivalents) at 24 h (MD, − 11.51 mg; 95% CI − 17.05 to − 5.96) and 48 h (MD, − 15.87 mg; 95% CI − 26.36 to − 5.38), supported by sufficient data confirmed by TSA. The postoperative pain scores were significantly reduced by QLB at 4 h, 6 h, 12 h, 24 h, and 48 h postoperatively by QLB compared with control. Moreover, the time to first request for rescue analgesic and the incidence of PONV were also significantly reduced by QLB. The quality of evidence of most results were low and moderate assessed by GRADE.

scholarly journals Effect of Bilateral Quadratus Lumborum Block Type I on Patient Satisfaction and Incidence of Chronic Postsurgical Pain Following Cesarean Section-A Randomized Controlled Trial

2021 ◽  
Vol 18 (17) ◽  
pp. 9138
Author(s):  
Marcin Mieszkowski ◽  
Marek Janiak ◽  
Michał Borys ◽  
Paweł Radkowski ◽  
Marta Mieszkowska ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Cesarean Section ◽  
Pain Therapy ◽  
Control Group ◽  
Block Type ◽  
Type I ◽  
Postsurgical Pain ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum ◽  
Chronic Postsurgical Pain

Background: Quadratus lumborum block (QLB) provides a reduction in pain scores and opioid consumption after cesarean section (CS). Intrathecal morphine (ITM) is still considered as the gold standard of acute postoperative pain therapy, but it does have some significant side effects. The aim of this clinical study was to evaluate whether performing the quadratus lumborum block type I in patients undergoing CS would be associated with an increased satisfaction of pain therapy and a decreased incidence of chronic postsurgical pain (CPSP). Methods: Sixty patients scheduled for elective CS were enrolled. All patients received spinal anesthesia and were randomly allocated to either the QLB group (received bilateral quadratus lumborum block type I with the use of 24 m mL 0.375% ropivacaine) or the control group (received no block). The level of satisfaction was evaluated using a three-step scale and the answers provided in a questionnaire regarding the patients’ satisfaction with the method of postoperative pain treatment in the first 48 h. After a 6-month period, all patients were interviewed to evaluate the incidence and possible severity of CPSP. Results: Satisfaction scores were significantly lower in the QLB group than in the control group (p = 0.0000). There were no significant differences between the QLB and control groups regarding the occurrence of chronic postsurgical pain after 6 months following CS (p = 0.102). No statistical differences between the groups were recorded when we compared the results of the questionnaire after a period of 48 h from CS (the number of participants were limited in number). Conclusions: QLB type I is an analgetic option that increased the satisfaction of parturients with pain therapy after CS compared to patients who did not receive the block, and there is a tendency for a lower incidence of CPSP.

scholarly journals Quadratus lumborum block for postoperative analgesia after cesarean section: a meta-analysis of randomized controlled trials with trial sequential analysis

2021 ◽  
Author(s):  
Zhigang Zhao ◽  
Kaiming Xu ◽  
Yanting Zhang ◽  
Gang Chen ◽  
Youfa Zhou
Keyword(s):  
Cesarean Section ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Analgesic Efficacy ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Sufficient Data ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
Quadratus Lumborum

Abstract The aim of this study was to assess the analgesic efficacy of QLB versus controls in women undergoing cesarean section (CS). We systematically searched Cochrane Library, PUBMED, EMBASE, VIP, WANFANG, and China National Knowledge Infrastructure. Trials were eligible if parturients received QLB during CS. GRADE system was used to assess the certainty of evidence and Trial sequential analyses (TSA) were performed to determine whether the results are supported by sufficient data. Thirteen studies involving 1269 patients were included. Compared to controls, QLB significantly reduced the cumulative postoperative intravenous opioid consumption (in milligram morphine equivalents) at 24h (MD, -11.51 mg; 95% CI -17.05 to -5.96) and 48h (MD, -15.87 mg; 95% CI -26.36 to -5.38), supported by sufficient data confirmed by TSA. The postoperative pain scores were significantly reduced by QLB at 4h, 6h, 12h, 24h, and 48h postoperatively by QLB compared with control. Moreover, the time to first request for rescue analgesic and the incidence of PONV were also significantly reduced by QLB. The quality of evidence of most results were low and moderate assessed by GRADE.

scholarly journals BADUANJIN EXERCISE TO TREAT FOR LUMBAR DISC HERNIATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Author(s):  
XIAOKUN LI ◽  
SHUSHENG GUO ◽  
HONG DONG ◽  
LIMING ZHOU
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Data Extraction ◽  
Lumbar Disc ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Treatment Efficiency ◽  
Vas Score ◽  
Long Time

This study aimed to systematically evaluate the effectiveness of Baduanjin in the treatment of lumbar disc herniation (LDH). We searched PubMed, the Cochrane Library, EMBASE, Web of Science (WOS), CNKI, and Wanfang Databases from their inception until August 1, 2021, to collect the randomized controlled trials (RCTs) of Baduanjin in the treatment of LDH. After literature screening, data extraction, and quality evaluation by two independent researchers, the RevMan 5.4 software was used for meta-analysis. A total of 13 studies, involving 853 patients were finally included. The results showed that compared with the control group, the Baduanjin group showed remarkably improved treatment efficiency ([Formula: see text], 95% CI (1.05, 1.23), [Formula: see text]), JOA score ([Formula: see text], 95% CI (0.56, 4.68), [Formula: see text]), and VAS score ([Formula: see text], 95% CI ([Formula: see text], [Formula: see text]), [Formula: see text]). The Baduanjin group exhibited higher VAS scores than the control group in different intervention times (within 1 month, 1–2 months, and more than two months) ([Formula: see text]). Moreover, the JOA score of the Baduanjin was better than that of the control group in the presence of intervention for more than two months ([Formula: see text], 95% CI (1.05, 7.30), [Formula: see text]). In the comparison of exercise therapy, Baduanjin has more advantages than traditional rehabilitation training, as manifested by the improved VAS score ([Formula: see text], 95% CI ([Formula: see text], [Formula: see text]), [Formula: see text]) and JOA score ([Formula: see text], 95% CI (1.63, 3.09), [Formula: see text]). Conclusion: Baduanjin can significantly improve the rehabilitation evaluation scores of LDH patients and the treatment efficiency, and its curative effect was more obvious in a long time.

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