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Regional techniques for pain management following laparoscopic elective colonic resection: A systematic review

INTRODUCTION: Pain management is an integral part of Enhanced Recovery After Surgery (ERAS) following laparoscopic colonic resection. A variety of regional and neuraxial techniques were proposed, but their efficacy is still controversial. This systematic review evaluates published evidence on analge...

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Autores principales: Daghmouri, Mohamed Aziz, Chaouch, Mohamed Ali, Oueslati, Maroua, Rebai, Lotfi, Oweira, Hani
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8648937/
https://www.ncbi.nlm.nih.gov/pubmed/34925820
http://dx.doi.org/10.1016/j.amsu.2021.103124
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author Daghmouri, Mohamed Aziz
Chaouch, Mohamed Ali
Oueslati, Maroua
Rebai, Lotfi
Oweira, Hani
author_facet Daghmouri, Mohamed Aziz
Chaouch, Mohamed Ali
Oueslati, Maroua
Rebai, Lotfi
Oweira, Hani
author_sort Daghmouri, Mohamed Aziz
collection PubMed
description INTRODUCTION: Pain management is an integral part of Enhanced Recovery After Surgery (ERAS) following laparoscopic colonic resection. A variety of regional and neuraxial techniques were proposed, but their efficacy is still controversial. This systematic review evaluates published evidence on analgesic techniques and their impact on postoperative analgesia and recovery for laparoscopic colonic surgery patients. METHODS: We conducted bibliographic research on May 10, 2021, through PubMed, Cochrane database, and Google scholar. We retained meta-analysis and randomized clinical trials. We graded the strength of clinical data and subsequent recommendations according to the Oxford Centre for Evidence-Based Medicine. RESULTS: Twelve studies were included. Thoracic epidural analgesia improved postoperative analgesia and bowel function following laparoscopic colectomy. However, it lengthens the hospital stay. Transversus abdominis plane block was as effective as thoracic epidural analgesia concerning pain control but with better postoperative recovery and lower length of hospital stay. Moreover, Lidocaine intravenous infusion improved postoperative pain management and recovery; Quadratus lumborum block provided similar postoperative analgesia and recovery. Finally, wound infiltration reduced postoperative pain without improving recovery of bowel function, and it could be proposed as an alternative to thoracic epidural analgesia. CONCLUSIONS: Several analgesic techniques have been investigated. We found that abdominal wall blocks were as effective as thoracic epidural analgesia for pain management but with lower hospital stay and better recovery. We registered this review on PROSPERO (ID: CRD42021279228).
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spelling pubmed-86489372021-12-17 Regional techniques for pain management following laparoscopic elective colonic resection: A systematic review Daghmouri, Mohamed Aziz Chaouch, Mohamed Ali Oueslati, Maroua Rebai, Lotfi Oweira, Hani Ann Med Surg (Lond) Systematic Review / Meta-analysis INTRODUCTION: Pain management is an integral part of Enhanced Recovery After Surgery (ERAS) following laparoscopic colonic resection. A variety of regional and neuraxial techniques were proposed, but their efficacy is still controversial. This systematic review evaluates published evidence on analgesic techniques and their impact on postoperative analgesia and recovery for laparoscopic colonic surgery patients. METHODS: We conducted bibliographic research on May 10, 2021, through PubMed, Cochrane database, and Google scholar. We retained meta-analysis and randomized clinical trials. We graded the strength of clinical data and subsequent recommendations according to the Oxford Centre for Evidence-Based Medicine. RESULTS: Twelve studies were included. Thoracic epidural analgesia improved postoperative analgesia and bowel function following laparoscopic colectomy. However, it lengthens the hospital stay. Transversus abdominis plane block was as effective as thoracic epidural analgesia concerning pain control but with better postoperative recovery and lower length of hospital stay. Moreover, Lidocaine intravenous infusion improved postoperative pain management and recovery; Quadratus lumborum block provided similar postoperative analgesia and recovery. Finally, wound infiltration reduced postoperative pain without improving recovery of bowel function, and it could be proposed as an alternative to thoracic epidural analgesia. CONCLUSIONS: Several analgesic techniques have been investigated. We found that abdominal wall blocks were as effective as thoracic epidural analgesia for pain management but with lower hospital stay and better recovery. We registered this review on PROSPERO (ID: CRD42021279228). Elsevier 2021-12-01 /pmc/articles/PMC8648937/ /pubmed/34925820 http://dx.doi.org/10.1016/j.amsu.2021.103124 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Systematic Review / Meta-analysis
Daghmouri, Mohamed Aziz
Chaouch, Mohamed Ali
Oueslati, Maroua
Rebai, Lotfi
Oweira, Hani
Regional techniques for pain management following laparoscopic elective colonic resection: A systematic review
title Regional techniques for pain management following laparoscopic elective colonic resection: A systematic review
title_full Regional techniques for pain management following laparoscopic elective colonic resection: A systematic review
title_fullStr Regional techniques for pain management following laparoscopic elective colonic resection: A systematic review
title_full_unstemmed Regional techniques for pain management following laparoscopic elective colonic resection: A systematic review
title_short Regional techniques for pain management following laparoscopic elective colonic resection: A systematic review
title_sort regional techniques for pain management following laparoscopic elective colonic resection: a systematic review
topic Systematic Review / Meta-analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8648937/
https://www.ncbi.nlm.nih.gov/pubmed/34925820
http://dx.doi.org/10.1016/j.amsu.2021.103124
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