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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...

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Autores principales: Mărgărit, Simona, Bartoș, Adrian, Laza, Laura, Osoian, Cristiana, Turac, Robert, Bondar, Oszkar, Leucuța, Daniel-Corneliu, Munteanu, Lidia, Vasian, Horațiu Nicolae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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.
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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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