ABSTRACT
BACKGROUND: Anxiety prior to caesarean section can lead to a negative birth experience, which may affect different aspects of woman's life in the long term. Improving preoperative information may result in lower anxiety leading to a more positive birth experience. Thus, we aimed to evaluate the impact of informational video before planned caesarean delivery on maternal anxiety and satisfaction. METHODS: Four different databases were searched from inception till March 2023. We selected randomised controlled trials (RCTs) that compared educational or informative videos about the aspects of the expected caesarean delivery process versus no preoperative information in the control group. No language restrictions were imposed. We used Revman software during performing our meta-analysis. Our main outcomes were preoperative and postoperative anxiety as well as maternal satisfaction post-procedure. RESULTS: Six RCTs were retrieved with a total number of 702 patients. Informative video significantly reduced the anxiety level before caesarean delivery in comparison with the control group (MD = -4.21, 95% CI [-5.46, -2.95], p<0001). Moreover, the postoperative anxiety level was significantly improved in the informational video group (MD = -4.71, 95% CI [-7.06, -2.36], p<0001). In addition, there was a significant improvement in maternal satisfaction score after caesarean delivery among the informational video group (p = 0.001). CONCLUSIONS: Informational video prior to caesarean delivery decreases preoperative and postoperative anxiety levels with improvement in maternal post-procedure satisfaction. However, the existing evidence is limited by several shortcomings, chiefly small sample size. More trials with larger sample size are required to confirm our findings.
ABSTRACT
We aimed to evaluate the efficacy of superior hypogastric plexus (SHP) block in pain relief among women undergoing hysterectomy. Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021 for the available randomized clinical trials (RCTs). We included RCTs that compared SHP block (intervention group) to saline (control group) in hysterectomy. Our primary outcomes were pain scores at different time intervals using the Visual Analog Scale (VAS). Our secondary outcomes were postoperative opioid consumption within 24 hours and postoperative nausea and vomiting incidence. We extracted the available data from included studies and pooled them in a meta-analysis model using RevMan software. Four RCTs with a total number of 289 patients met our inclusion criteria. The VAS pain scores were significantly declined at post-anesthesia care unit (PACU), 2, 6, and 12 hours postoperatively among SHP block group (p < 0.05). However, no significant difference was reported in VAS pain score 1 day postoperatively between intervention and control groups. Moreover, SHP block significantly reduced the postoperative opioid consumption and incidence of nausea and vomiting (p = 0.03 & p = 0.003). In conclusion, superior hypogastric plexus block effectively reduces postoperative pain, opioid consumption, and incidence of nausea and vomiting post-hysterectomy.
