The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
World J Surg. 2022 Nov;46(11):2733-2743. doi: 10.1007/s00268-022-06685-9. Epub 2022 Aug 6.
The effectiveness of intraperitoneal local anesthesia (IPLA) has been confirmed in other fields, but its use in bariatric surgery remains debatable. This study aimed to evaluate the analgesic effect of IPLA in bariatric surgery.
PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to February 2022. All randomized controlled trials (RCTs) assessing IPLA's analgesic effect in bariatric surgery were included in this study. Pain-related indicators were the outcome.
Ten RCTs with 979 patients were included. Postoperative pain scores were significantly lower in IPLA group. Subgroup analysis demonstrated that IPLA was associated with lower pain scores in 6 h and at 24 h compared to the control group, without significant differences at 8, 12, and 48 h. Meanwhile, IPLA reduced the dose of opioids taken postoperatively. Additionally, there were no differences in adverse events between the two groups. As far as the number of postoperative analgesics used and hospital stays were concerned, our results did not show statistical differences between the two groups.
IPLA can reduce postoperative pain safely and effectively, particularly during the early postoperative stage.
腹腔内局部麻醉（IPLA）在其他领域的有效性已得到证实，但在减肥手术中的应用仍存在争议。本研究旨在评估 IPLA 在减肥手术中的镇痛效果。
检索 PubMed、Web of Science、Embase 和 Cochrane Library 自成立至 2022 年 2 月的所有评估 IPLA 在减肥手术中镇痛效果的随机对照试验（RCT）。本研究纳入了所有评估 IPLA 在减肥手术中镇痛效果的 RCT。疼痛相关指标为结局。
纳入了 10 项 RCT，共 979 例患者。IPLA 组术后疼痛评分明显较低。亚组分析显示，与对照组相比，IPLA 组在 6 h 和 24 h 时疼痛评分较低，但在 8 h、12 h 和 48 h 时差异无统计学意义。同时，IPLA 减少了术后阿片类药物的用量。此外，两组不良反应发生率无差异。就术后使用的镇痛药数量和住院时间而言，两组之间的结果无统计学差异。
IPLA 可安全有效地减轻术后疼痛，尤其在术后早期。
