Effect of different regional anaesthesia techniques on postoperative analgesia following percutaneous nephrolithotomy: A systematic review and network meta-analysis
Background and Aims: The optimal analgesia for percutaneous nephrolithotomy (PCNL) remains uncertain. This study aims to conduct a systematic review and network meta-analysis to compare the efficacy of various analgesic strategies for PCNL. Methods: We searched PubMed, ScienceDirect, ClinicalTrials....
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Indian Journal of Anaesthesia |
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| Online Access: | https://journals.lww.com/10.4103/ija.ija_679_24 |
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| _version_ | 1832087340054478848 |
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| author | Kun Long Chengfu Zhou Jingqiu Liang Xixi Tang Zhijian Li Qi Chen |
| author_facet | Kun Long Chengfu Zhou Jingqiu Liang Xixi Tang Zhijian Li Qi Chen |
| author_sort | Kun Long |
| collection | DOAJ |
| description | Background and Aims:
The optimal analgesia for percutaneous nephrolithotomy (PCNL) remains uncertain. This study aims to conduct a systematic review and network meta-analysis to compare the efficacy of various analgesic strategies for PCNL.
Methods:
We searched PubMed, ScienceDirect, ClinicalTrials.gov, MEDLINE, Web of Science, Ovid and EMBASE to identify all relevant randomised controlled trials published up to January 2024. Our review was prospectively registered with PROSPERO (ID: CRD42024504578). The identified methods included erector spinae plane block (ESPB), paravertebral block (PVB), intercostal nerve block (ICNB), quadratus lumborum block (QLB) and local infiltration. Our primary outcomes consisted of 24-h cumulative opioid consumption and the time to first use of opioid medication postoperatively. Secondary outcomes encompassed pain scores at 2, 6, 12 and 24 h postoperatively, as well as occurrences of postoperative nausea and vomiting.
Results:
Overall, 27 trials met our inclusion criteria. QLB, PVB and ESPB demonstrated significant advantages in reducing 24-h postoperative opioid consumption and providing effective analgesia at all measured postoperative time points within 24 h, compared to the placebo group. However, there was no statistical difference between the three interventions. Similarly, there were no statistical differences in all outcomes between the ICNB and infiltration groups compared to the placebo group.
Conclusions:
ESPB, PVB and QLB offer significant analgesic benefits for PCNL compared to placebo, with no significant differences in efficacy among them. Due to limited evidence, ICNB and local infiltration were found not to be more effective than placebo. |
| format | Article |
| id | doaj-art-41c7b2b69ddd42e48e93e442d4749761 |
| institution | Kabale University |
| issn | 0019-5049 0976-2817 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj-art-41c7b2b69ddd42e48e93e442d47497612025-02-06T05:26:09ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172025-01-01691122210.4103/ija.ija_679_24Effect of different regional anaesthesia techniques on postoperative analgesia following percutaneous nephrolithotomy: A systematic review and network meta-analysisKun LongChengfu ZhouJingqiu LiangXixi TangZhijian LiQi ChenBackground and Aims: The optimal analgesia for percutaneous nephrolithotomy (PCNL) remains uncertain. This study aims to conduct a systematic review and network meta-analysis to compare the efficacy of various analgesic strategies for PCNL. Methods: We searched PubMed, ScienceDirect, ClinicalTrials.gov, MEDLINE, Web of Science, Ovid and EMBASE to identify all relevant randomised controlled trials published up to January 2024. Our review was prospectively registered with PROSPERO (ID: CRD42024504578). The identified methods included erector spinae plane block (ESPB), paravertebral block (PVB), intercostal nerve block (ICNB), quadratus lumborum block (QLB) and local infiltration. Our primary outcomes consisted of 24-h cumulative opioid consumption and the time to first use of opioid medication postoperatively. Secondary outcomes encompassed pain scores at 2, 6, 12 and 24 h postoperatively, as well as occurrences of postoperative nausea and vomiting. Results: Overall, 27 trials met our inclusion criteria. QLB, PVB and ESPB demonstrated significant advantages in reducing 24-h postoperative opioid consumption and providing effective analgesia at all measured postoperative time points within 24 h, compared to the placebo group. However, there was no statistical difference between the three interventions. Similarly, there were no statistical differences in all outcomes between the ICNB and infiltration groups compared to the placebo group. Conclusions: ESPB, PVB and QLB offer significant analgesic benefits for PCNL compared to placebo, with no significant differences in efficacy among them. Due to limited evidence, ICNB and local infiltration were found not to be more effective than placebo.https://journals.lww.com/10.4103/ija.ija_679_24analgesiaerector spinae plane blockintercostal nerve blocklocal infiltrationnetwork meta-analysisparavertebral blockpcnlpercutaneous nephrolithotomyquadratus lumborum blockregional anaesthesia |
| spellingShingle | Kun Long Chengfu Zhou Jingqiu Liang Xixi Tang Zhijian Li Qi Chen Effect of different regional anaesthesia techniques on postoperative analgesia following percutaneous nephrolithotomy: A systematic review and network meta-analysis Indian Journal of Anaesthesia analgesia erector spinae plane block intercostal nerve block local infiltration network meta-analysis paravertebral block pcnl percutaneous nephrolithotomy quadratus lumborum block regional anaesthesia |
| title | Effect of different regional anaesthesia techniques on postoperative analgesia following percutaneous nephrolithotomy: A systematic review and network meta-analysis |
| title_full | Effect of different regional anaesthesia techniques on postoperative analgesia following percutaneous nephrolithotomy: A systematic review and network meta-analysis |
| title_fullStr | Effect of different regional anaesthesia techniques on postoperative analgesia following percutaneous nephrolithotomy: A systematic review and network meta-analysis |
| title_full_unstemmed | Effect of different regional anaesthesia techniques on postoperative analgesia following percutaneous nephrolithotomy: A systematic review and network meta-analysis |
| title_short | Effect of different regional anaesthesia techniques on postoperative analgesia following percutaneous nephrolithotomy: A systematic review and network meta-analysis |
| title_sort | effect of different regional anaesthesia techniques on postoperative analgesia following percutaneous nephrolithotomy a systematic review and network meta analysis |
| topic | analgesia erector spinae plane block intercostal nerve block local infiltration network meta-analysis paravertebral block pcnl percutaneous nephrolithotomy quadratus lumborum block regional anaesthesia |
| url | https://journals.lww.com/10.4103/ija.ija_679_24 |
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