比较腹直肌鞘阻滞与局部麻醉在小儿脐疝修补术中的镇痛效果：系统评价和荟萃分析。

Comparison of rectus sheath block and local anesthetic for analgesia in pediatric umbilical hernia repair: A systematic review and meta-analysis.

机构信息

Department of Cardiothoracic Surgery and Abdominal Hernia Surgery, The People's Hospital of Kai Zhou District, Chongqing, and.

Department of Gastrointestinal Surgery and Breast Surgery, The People's Hospital of Kai Zhou District, Chongqing.

出版信息

Medicine (Baltimore). 2022 Sep 9;101(36):e30391. doi: 10.1097/MD.0000000000030391.

BACKGROUND

Pediatric umbilical hernia repair could cause considerable postoperative discomfort. This study aimed to compare the analgesia between rectus sheath block and local anesthetic infiltration in child pediatric umbilical hernia repair.

METHODS

The relevant randomized controlled trials were searched from PubMed, Embase, Web of Science, EBSCO, and Cochrane library databases from its inception to October 2020. The random-effects model was used for meta-analysis.

RESULTS

Four randomized controlled trials were included in the meta-analysis. The 4 studies were published between 2006 and 2017, with sample sizes ranging from 13 to 52 and a total of 143 individuals across the 4 studies. The Jadad scores of the 4 included studies ranged from 4 to 5, and all 4 studies were considered high quality based on quality assessment. There was no difference in analgesic effect at 10 minutes (standardized mean difference [SMD] = -0.19; 95% confidence interval [CI] = -1.52 to 1.16; P = .78), 30 minutes (SMD = -0.37; 95% CI = -1.53 to 0.78; P = .52), 1 hour (SMD = -0.73; 95% CI = -2.00 to 0.53; P = .26) after surgery. Besides, there was no significant difference in postoperative nausea (risk ratio = 0.95; 95% CI = 0.18 to 5.02; P = .95) and postoperative morphine use in morphine equivalents (mean difference = -0.95; 95% CI = -0.06 to 0.01; P = .12).

CONCLUSION

Rectus sheath block and local anesthetic are effective methods for analgesia in pediatric umbilical hernia repair.

背景

小儿脐疝修补术可引起相当大的术后不适。本研究旨在比较腹直肌鞘阻滞与局部麻醉浸润在小儿脐疝修补术中的镇痛效果。

方法

从 PubMed、Embase、Web of Science、EBSCO 和 Cochrane 图书馆数据库中检索相关的随机对照试验，检索时间从建库至 2020 年 10 月。采用随机效应模型进行荟萃分析。

结果

纳入的荟萃分析共有 4 项随机对照试验。这 4 项研究发表于 2006 年至 2017 年之间，样本量范围为 13 至 52 例，4 项研究共 143 例。4 项纳入研究的 Jadad 评分范围为 4 至 5 分，基于质量评估，所有 4 项研究均被认为是高质量的。术后 10 分钟（标准化均数差 [SMD] = -0.19；95%置信区间 [CI] = -1.52 至 1.16；P =.78）、30 分钟（SMD = -0.37；95% CI = -1.53 至 0.78；P =.52）、1 小时（SMD = -0.73；95% CI = -2.00 至 0.53；P =.26）的镇痛效果无差异。此外，术后恶心（风险比 = 0.95；95% CI = 0.18 至 5.02；P =.95）和术后吗啡等效物用量（均数差 = -0.95；95% CI = -0.06 至 0.01；P =.12）也无显著差异。