Pectoral nerve blocks and postoperative pain outcomes after mastectomy: a meta-analysis of randomized controlled trials

Lovett-Carter, Danielle; Kendall, Mark C.; McCormick, Zachary L.; Suh, Edward I; Cohen, Alexander; Oliveira, Gildàsio S. De

doi:10.1136/rapm-2019-100658

Cited by 44 publications

(30 citation statements)

References 37 publications

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“…The random effect model has an advantage to the fixed effect model since it does not rely on the assumption that a true effect size is the same in all combined studies [11]. Publication bias was evaluated by examining for asymmetric funnel plot using the Egger's regression test [12,13]. A one-sided P < 0.05 was considered as an indication of an asymmetric funnel plot.…”

Section: Meta-analysesmentioning

confidence: 99%

The association between labor epidural analgesia and postpartum depression: a systematic review and meta-analysis

et al. 2020

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Background: Previous studies have demonstrated that appropriate treatment for postoperative pain can lead to improvement in depressive symptoms, however the association between adequate intrapartum pain control and the development of postpartum depression is not clear. The purpose of the study was to examine the effects of labor epidural analgesia and postpartum depression. Methods: We performed a quantitative systematic review in compliance with the PRISMA statement. We conducted a search of PubMed, Embase, the Cochrane Database of Systematic Reviews and Google Scholar databases. The primary outcome was a positive screen of postpartum depression among women who received labor epidural analgesia up to 3 months into the postpartum period. Meta-analysis was performed using the random effect model. Results: Of the 148 studies available, 9 studies with 4442 patients were included in the analysis. The use of labor analgesia on positive depression screen compared to control revealed no significant effect, OR (95% CI) of 1.02 (0.62 to 1.66, P = 0.94). Conclusion: Based on current literature, the use of epidural analgesia for pain relief during labor doesn't appear to affect the likelihood of postpartum depression. Future studies are warranted to further investigate these findings and identity other possible preventative interventions that reduce postpartum depression.

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Section: Meta-analysesmentioning

confidence: 99%

The association between labor epidural analgesia and postpartum depression: a systematic review and meta-analysis

et al. 2020

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“…A large variety of regional anesthesia techniques have been commonly used to minimize postoperative pain [4][5][6]. In addition, several techniques (e.g., transverse abdominis plane blocks, pectoral nerve blocks, brachial plexus blocks) have been evaluated in quantitative systematic reviews [7][8][9]. These techniques have emerged as effective non-opioid strategies to reduce post-surgical pain.…”

Section: Introductionmentioning

confidence: 99%

The effect of ultrasound-guided erector spinae plane block on postsurgical pain: a meta-analysis of randomized controlled trials

et al. 2020

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Background: The effect of erector spinae plane block has been evaluated by clinical trials leading to a diversity of results. The main objective of the current investigation is to compare the analgesic efficacy of erector spinae plane block to no block intervention in patients undergoing surgical procedures. Methods: We performed a quantitative systematic review of randomized controlled trials in PubMed, Embase, Cochrane Library, and Google Scholar electronic databases from their inception through July 2019. Included trials reported either on opioid consumption or pain scores as postoperative pain outcomes. Methodological quality of included studies was evaluated using Cochrane Collaboration's tool. Results: Thirteen randomized controlled trials evaluating 679 patients across different surgical procedures were included. The aggregated effect of erector spinae plane block on postoperative opioid consumption revealed a significant effect, weighted mean difference of − 8.84 (95% CI: − 12.54 to − 5.14), (P < 0.001) IV mg morphine equivalents. The effect of erector spinae plane block on post surgical pain at 6 h compared to control revealed a significant effect weighted mean difference of − 1.31 (95% CI: − 2.40 to − 0.23), P < 0.02. At 12 h, the weighted mean difference was of − 0.46 (95% CI: − 1.01 to 0.09), P = 0.10. No block related complications were reported. Conclusions: Our results provide moderate quality evidence that erector spinae plane block is an effective strategy to improve postsurgical analgesia.

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“…A variety of techniques were evaluated such as transverse abdominis plane (TAP) blocks, pectoral nerve blocks, and brachial plexus block. [1][2][3][4] Erector spinae plane (ESP) block was first described by Forero et al 5 It is an interfacial plane block used for the treatment of thoracic neuropathic pain. It consists in the injection of a local anesthetic (LA) into the fascial plane situated between the erector spinae muscle and the transverse process of the vertebra.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies with high level of evidence confirmed that ESP block could be an effective procedure to improve postoperative analgesia after digestive surgery. 3,6,7 However, in these studies various surgical procedures with anatomical differences were included, which cause significant heterogeneity among the studies. As far as we know, there has been no quantitative systematic review which evaluated the efficacy of ESP block in the management of postoperative pain in a specific laparoscopic surgery.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Systematic Review and Meta‐analysis of Randomized Controlled Trials

et al. 2020

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Background: Erector spinae plane (ESP) block is a novel regional anesthetic technique. Its application for postoperative analgesia has been increasing since 2016; however, its effectiveness remains uncertain and varies according to the type of surgery. This meta-analysis aimed to assess the analgesic efficacy of ESP block in patients undergoing laparoscopic cholecystectomy. Methods: Literature searches of electronic databases and manual searches up to June 1, 2020 were performed. Review Manager Version 5.3 was used for pooled estimates. We included only randomized controlled trials (RCTs) in this meta-analysis. The random-effects meta-analysis model was used, and metaregression was applied when appropriate. Results: A total of five RCTs consisting of 250 patients were included (124 in the ESP block group vs. 126 in the control group). Bilateral ESP block showed a significant reduction in postoperative intravenous opioid consumption reported up to 24 hours after surgery (mean difference [MD] = À4.46, 95% confidence interval [CI] [À5.50 to À3.42], P < 0.001) and in the time to first rescue analgesic (MD = 73.27 minutes, 95% CI [50.39 to 96.15], P < 0.001). According to the results of four studies, the postoperative pain score was lower in the ESP group compared with the control group at both rest and movement. There were no differences between the two groups as concerns nausea (odds ratio [OR] = 0.45, 95% CI [0.13 to 1.52], P = 0.20) and vomiting (OR = 0.37, 95% CI [0.10 to 1.35], P = 0.13). No block-related complications were noted. Conclusion: This meta-analysis showed that bilateral ultrasound-guided ESP block could be considered as an effective option to reduce opioid consumption and the time to first rescue analgesic and seems to be also a safe technique in adults undergoing laparoscopic cholecystectomy. &

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Pectoral nerve blocks and postoperative pain outcomes after mastectomy: a meta-analysis of randomized controlled trials

Cited by 44 publications

References 37 publications

The association between labor epidural analgesia and postpartum depression: a systematic review and meta-analysis

The association between labor epidural analgesia and postpartum depression: a systematic review and meta-analysis

The effect of ultrasound-guided erector spinae plane block on postsurgical pain: a meta-analysis of randomized controlled trials

Bilateral Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Systematic Review and Meta‐analysis of Randomized Controlled Trials

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