RESUMEN
Background@#Different regional anesthesia (RA) techniques have been used for laparoscopic cholecystectomy (LC), but there is no consensus on their comparative effectiveness. Our objective was to evaluate the effect of RA techniques on patients undergoing LC using a network meta-analysis approach. @*Methods@#We conducted a systematic review and network meta-analysis. We searched PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science (Science and Social Science Citation Index) using the following PICOS criteria: (P) adult patients undergoing LC; (I) any RA single-shot technique with injection of local anesthetics; (C) placebo or no intervention; (O) postoperative opioid consumption expressed as morphine milligram equivalents (MME), rest pain at 12 h and 24 h post-operation, postoperative nausea and vomiting (PONV), length of stay; and (S) randomized controlled trials. @*Results@#A total of 84 studies were included. With the exception of the rectus sheath block (P = 0.301), the RA techniques were superior to placebo at reducing opioid consumption. Regarding postoperative pain, the transversus abdominis plane (TAP) block (−1.80 on an 11-point pain scale) and erector spinae plane (ESP) block (−1.33 on an 11-point pain scale) were the most effective at 12 and 24 h. The TAP block was also associated with the greatest reduction in PONV. @*Conclusions@#RA techniques are effective at reducing intraoperative opioid use, postoperative pain, and PONV in patients undergoing LC. Patients benefit the most from the bilateral paravertebral, ESP, quadratus lumborum, and TAP blocks.
RESUMEN
Objectives: To compare ultrasound guidance [USG] and electrical neurostimulation guidance [ENSG] in axillary brachial plexus block in terms of block performing time, sensory and motor block quality, and patient satisfaction
Methodology: 200 patients undergoing elective carpal tunnel syndrome surgery were randomly assigned to one of two groups equally; the USG group or the ENSG group. Axillary blocks were performed with a mixture of 15 ml of lidocaine 2% and 15 ml of bupivacaine 0.5% [a total of 30 ml solution]. Sensory block was evaluated with a pinprick test and motor block was evaluated via the Bromage scale by a blinded observer
Results: Block performing time was significantly shorter in the USG group than in the ENSG group [P<0.001]. The sensory and motor block onset times were significantly shorter and the additional analgesic requirements were significantly lower in the USG group than in the ENSG group [P<0.001]
Conclusion: USG is better than ENSG in axillary brachial plexus block in terms of block performing time, block quality and patient satisfaction