Nerve stimulator–guided pudendal nerve block vs general anesthesia for postoperative pain management after anterior and posterior vaginal wall repair: a prospective randomized trial

Khalil, I.; Itani, Saad Eddine; Naja, Zeina; Naja, Ahmad Salaheddine; Ziade, Fouad; Ayoubi, Jean-Marc; El-Rajab, Mariam; Naja, Zoher

doi:10.1016/j.jclinane.2016.07.024

Cited by 15 publications

(32 citation statements)

References 22 publications

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“…). After duplicates had been excluded, we identified 31 trials including 27 primary interventional RCTs and four follow‐up studies . Seventeen studies were included in the posterior repair group (14 first studies and 3 follow‐up studies) and 14 in the multicompartmental group (13 first studies and one follow‐up study).…”

Section: Resultsmentioning

confidence: 99%

A systematic review of reported outcomes and outcome measures in randomized trials evaluating surgical interventions for posterior vaginal prolapse to aid development of a core outcome set

Lourenço

Pergialiotis

Durnea

et al. 2020

Intl J Gynecology & Obste

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Background: Recent systematic reviews have demonstrated wide variations on outcome measure selection and outcome reporting in trials on surgical treatments for anterior, apical and mesh prolapse surgery. A systematic review of reported outcomes and outcome measures in posterior compartment vaginal prolapse interventions is highly warranted in the process of developing core outcome sets. Objective: To evaluate outcome and outcome measures reporting in posterior prolapse surgical trials. Search strategy: We searched MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL). Selection criteria: Randomized trials evaluating the efficacy and safety of different surgical interventions for posterior compartment vaginal prolapse.Data collection and analysis: Two researchers independently assessed studies for inclusion, evaluated methodological quality, and extracted relevant data. Methodological quality, outcome reporting quality and publication characteristics were evaluated.

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Section: Resultsmentioning

confidence: 99%

A systematic review of reported outcomes and outcome measures in randomized trials evaluating surgical interventions for posterior vaginal prolapse to aid development of a core outcome set

Lourenço

Pergialiotis

Durnea

et al. 2020

Intl J Gynecology & Obste

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“…Four randomized controlled trials [3,4,17,18] met our inclusion criteria and were included in the review. See Table 1.…”

Section: Included Studiesmentioning

confidence: 99%

“…One study [3] reported incomplete data that was unclear and not available after contact with the primary author. All trials were single center studies, published in English, conducted in the USA [4] , Lebanon [18] , Iran [3] and Kuwait [17] . Power calculations for sample size were reported for all of the included studies and were appropriate.…”

Section: Included Studiesmentioning

confidence: 99%

“…It also controls the external anal sphincter and the sphincter muscles of the bladder. [17,18] The high lipid solubility of Bupivacaine among other protein receptors makes it a commonly used agent for peripheral nerve blocks. [19,20] However, the use of bupivacaine in PNB has shown controversial results.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11][12][13][14] However, these results do not show effectiveness when compared against minimum clinical differences in postoperative pain. [3,4,17,18] Pain originates from multiple points during surgery and outcomes with pre-emptive analgesia vary with different surgical approaches. [2,3] For pelvic reconstructive surgeries, evidence of efficacy is uncertain and important considering the rise in the number of these surgeries performed within clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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The effectiveness of Bupivacaine as a pre-emptivepudendal block among patients undergoing vaginal surgeries: meta-analysis of randomized controlled trials

Rafique

Thompson

Al‐Jaroudi

et al. 2019

Preprint

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Background: Pre-emptive analgesia using pudendal nerve block (PNB) with bupivacaine is commonly used in clinical practice during pelvic floor and vaginal surgeries. However, its effectiveness is unclear. To update the evidence base we summarised short- and intermediate-term outcomes of pre-emptive analgesia using pudendal nerve block with bupivacaine as an approach in the management of pelvic floor and vaginal surgeries. Methods: We searched the CENTRAL, PubMed, ClinicalTrials.gov, google scholar and Open Grey from inception until April 2019. The citation lists of relevant papers were also searched. Randomized controlled trials (RCTs) of women who underwent perineal, pelvic floor or vaginal surgeries and received pre-emptive analgesia using a pudendal nerve block were included. Two authors independently screened and selected eligible trials as well as performed data extraction and quality assessment. Disagreements were resolved via consensus and an adjudicator was involved when consensus was not achieved. Data was narratively synthesized, when possible, data was pooled in RevMan 5 using random effects model. Results: Four RCTs with a total of 349 participants were eligible for inclusion. We found evidence of small effect for improvement in post-operative pain scores; requirements for opioids, SMD: -0.89 (95% CI: -1.19, -0.59) and non-steroidal anti-inflammatories SMD -1.04 (95% CI: -1.64, -0.43) in favour of the PNB versus control group. The risk ratio for adverse effects 0.42 (95% CI: 0.18, 0.99) favoured PNB. There was no significant difference between groups for length of hospital stay, MD: -0.82 (95% CI: -5.34, 3.69) and return to normal activity. Conclusion:We found inconclusive evidence that pre-emptive pudendal block using bupivacaine may improve postoperative pain and recovery in perineal, pelvic floor or vaginal surgeries. However, due to the scant and poor quality of evidence included in this systematic review, well-designed and adequately powered RCTs that adhere to reporting guidelines and evaluate key outcomes are needed to inform clinical guidelines on the use of pre-emptive pudendal block. Key words:pre-emptive analgesia, bupivacaine, pudendal nerve block, vaginal surgery, pelvic organ prolapse, systematic review, meta-analysis

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Chautems¹,

Brendl²,

Roche³

et al. 2018

Chirurgische Proktologie

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Nerve stimulator–guided pudendal nerve block vs general anesthesia for postoperative pain management after anterior and posterior vaginal wall repair: a prospective randomized trial

Cited by 15 publications

References 22 publications

A systematic review of reported outcomes and outcome measures in randomized trials evaluating surgical interventions for posterior vaginal prolapse to aid development of a core outcome set

A systematic review of reported outcomes and outcome measures in randomized trials evaluating surgical interventions for posterior vaginal prolapse to aid development of a core outcome set

The effectiveness of Bupivacaine as a pre-emptivepudendal block among patients undergoing vaginal surgeries: meta-analysis of randomized controlled trials

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