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Analgesic Modalities in Patients Undergoing Open Pancreatoduodenectomy—A Systematic Review and Meta-Analysis
Background: This systematic review explored the efficacy of different analgesic modalities and the impact on perioperative outcome in patients undergoing pancreatoduodenectomy. Methods: A systematic literature search was performed on PubMed, Embase, Web of Science, Scopus, and Cochrane Library Datab...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380756/ https://www.ncbi.nlm.nih.gov/pubmed/37510799 http://dx.doi.org/10.3390/jcm12144682 |
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author | Mărgărit, Simona Bartoș, Adrian Laza, Laura Osoian, Cristiana Turac, Robert Bondar, Oszkar Leucuța, Daniel-Corneliu Munteanu, Lidia Vasian, Horațiu Nicolae |
author_facet | Mărgărit, Simona Bartoș, Adrian Laza, Laura Osoian, Cristiana Turac, Robert Bondar, Oszkar Leucuța, Daniel-Corneliu Munteanu, Lidia Vasian, Horațiu Nicolae |
author_sort | Mărgărit, Simona |
collection | PubMed |
description | Background: This systematic review explored the efficacy of different analgesic modalities and the impact on perioperative outcome in patients undergoing pancreatoduodenectomy. Methods: A systematic literature search was performed on PubMed, Embase, Web of Science, Scopus, and Cochrane Library Database using the PRISMA framework. The primary outcome was pain scores on postoperative day one (POD1) and postoperative day two (POD2). The secondary outcomes included length of hospital stay (LOS) and specific procedure-related complications. Results: Five randomized controlled trials and ten retrospective cohort studies were included in the systematic review. Studies compared epidural analgesia (EA), patient-controlled analgesia (PCA), continuous wound infiltration (CWI), continuous bilateral thoracic paravertebral infusion (CTPVI), intrathecal morphine (ITM), and sublingual sufentanil. The pain scores on POD1 (p < 0.001) and POD2 (p = 0.05) were higher in the PCA group compared with the EA group. Pain scores were comparable between EA and CWI plus PCA or CTPVI on POD1 and POD2. Pain scores were comparable between EA and ITM on POD1. The procedure-related complications and length of hospital stay were not significantly different according to the type of analgesia. Conclusions: EA provided lower pain scores compared with PCA on the first postoperative day after pancreatoduodenectomy; the length of hospital stay and procedure-related complications were similar between EA and PCA. CWI and CTPVI provided similar pain relief to EA. |
format | Online Article Text |
id | pubmed-10380756 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-103807562023-07-29 Analgesic Modalities in Patients Undergoing Open Pancreatoduodenectomy—A Systematic Review and Meta-Analysis Mărgărit, Simona Bartoș, Adrian Laza, Laura Osoian, Cristiana Turac, Robert Bondar, Oszkar Leucuța, Daniel-Corneliu Munteanu, Lidia Vasian, Horațiu Nicolae J Clin Med Systematic Review Background: This systematic review explored the efficacy of different analgesic modalities and the impact on perioperative outcome in patients undergoing pancreatoduodenectomy. Methods: A systematic literature search was performed on PubMed, Embase, Web of Science, Scopus, and Cochrane Library Database using the PRISMA framework. The primary outcome was pain scores on postoperative day one (POD1) and postoperative day two (POD2). The secondary outcomes included length of hospital stay (LOS) and specific procedure-related complications. Results: Five randomized controlled trials and ten retrospective cohort studies were included in the systematic review. Studies compared epidural analgesia (EA), patient-controlled analgesia (PCA), continuous wound infiltration (CWI), continuous bilateral thoracic paravertebral infusion (CTPVI), intrathecal morphine (ITM), and sublingual sufentanil. The pain scores on POD1 (p < 0.001) and POD2 (p = 0.05) were higher in the PCA group compared with the EA group. Pain scores were comparable between EA and CWI plus PCA or CTPVI on POD1 and POD2. Pain scores were comparable between EA and ITM on POD1. The procedure-related complications and length of hospital stay were not significantly different according to the type of analgesia. Conclusions: EA provided lower pain scores compared with PCA on the first postoperative day after pancreatoduodenectomy; the length of hospital stay and procedure-related complications were similar between EA and PCA. CWI and CTPVI provided similar pain relief to EA. MDPI 2023-07-14 /pmc/articles/PMC10380756/ /pubmed/37510799 http://dx.doi.org/10.3390/jcm12144682 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Systematic Review Mărgărit, Simona Bartoș, Adrian Laza, Laura Osoian, Cristiana Turac, Robert Bondar, Oszkar Leucuța, Daniel-Corneliu Munteanu, Lidia Vasian, Horațiu Nicolae Analgesic Modalities in Patients Undergoing Open Pancreatoduodenectomy—A Systematic Review and Meta-Analysis |
title | Analgesic Modalities in Patients Undergoing Open Pancreatoduodenectomy—A Systematic Review and Meta-Analysis |
title_full | Analgesic Modalities in Patients Undergoing Open Pancreatoduodenectomy—A Systematic Review and Meta-Analysis |
title_fullStr | Analgesic Modalities in Patients Undergoing Open Pancreatoduodenectomy—A Systematic Review and Meta-Analysis |
title_full_unstemmed | Analgesic Modalities in Patients Undergoing Open Pancreatoduodenectomy—A Systematic Review and Meta-Analysis |
title_short | Analgesic Modalities in Patients Undergoing Open Pancreatoduodenectomy—A Systematic Review and Meta-Analysis |
title_sort | analgesic modalities in patients undergoing open pancreatoduodenectomy—a systematic review and meta-analysis |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380756/ https://www.ncbi.nlm.nih.gov/pubmed/37510799 http://dx.doi.org/10.3390/jcm12144682 |
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