Bao Xingjun, Liu Ming, Li Jie, Yao Huibao, Liu Hongquan, Tang Gonglin, Wang Xiaofeng, Zhou Zhongbao, Wu Jitao, Cui Yuanshan
Second Clinical Medical College, Binzhou Medical University, Yantai, China.
Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
Front Surg. 2023 Feb 3;10:1099628. doi: 10.3389/fsurg.2023.1099628. eCollection 2023.
To determine the efficacy of peripheral nerve block (PNB) in preventing postoperative catheter-related bladder discomfort (CRBD).
Up to July 1, 2022, the PubMed, Embase and Cochrane Central Register of Controlled Trials databases were searched, and all articles that met the PICOS (Patient, Intervention, Comparator, Outcome, Study design) criteria were enrolled. The included trials were evaluated using the Cochrane Collaboration's tool. Patients in the block group received bilateral PNB, while those in the non-block group did not need any additional procedure or simply achieved "sham block". CRBD was quantified using the visual analog scale (VAS) score, which was questioned and recorded at 0-1 h, 1-2 h, 4-8 h, 8-12 h and 12-24 h intervals. The incidences of CRBD, moderate to severe CRBD and postoperative nausea and vomiting (PONV) were meta-analysed.
Six trials with a total of 544 patients were considered. First, the block group had a lower incidence of CRBD than the non-block group at 0-1 h (OR 0.22; 95% CI, 0.18-0.08; < 0.0001), 1-2 h (OR 0.14; 95% CI, 0.08-0.26; < 0.00001), 4-8 h (OR 0.27; 95% CI, 0.13 to 0.58; < 0.0008) and 8-12 h (OR 0.51; 95% CI, 0.30 to 0.87; = 0.01). Second, the block group showed a lower incidence of moderate to severe CRBD than the non-block group at 0-1 h, 1-2 h and 4-8 h, and the ORs were 0.12 (95% CI, 0.03 to 0.49; = 0.003), 0.17 (95% CI, 0.08 to 0.37; < 0.00001) and 0.29 (95% CI, 0.15 to 0.55; = 0.0002),respectively. Finally, the block group was significantly associated with a decreased incidence of PONV (OR, 0.14; 95% CI, 0.05 to 0.39; = 0.0002).
This meta-analysis suggested that PNB markedly reduced the incidence and severity of early postoperative CRBD and decreased the occurrence of PONV.
确定外周神经阻滞（PNB）预防术后导尿管相关膀胱不适（CRBD）的疗效。
截至2022年7月1日，检索了PubMed、Embase和Cochrane对照试验中央注册库数据库，纳入了所有符合PICOS（患者、干预措施、对照、结局、研究设计）标准的文章。使用Cochrane协作网的工具对纳入的试验进行评估。阻滞组患者接受双侧PNB，而非阻滞组患者无需任何额外操作或仅进行“假阻滞”。使用视觉模拟量表（VAS）评分对CRBD进行量化，分别在0-1小时、1-2小时、4-8小时、8-12小时和12-24小时的时间间隔询问并记录该评分。对CRBD、中重度CRBD及术后恶心呕吐（PONV）的发生率进行荟萃分析。
共纳入6项试验，总计544例患者。首先，在0-1小时（OR 0.22；95%CI，0.18-0.08；<0.0001）、1-2小时（OR 0.14；95%CI，0.08-0.26；<0.00001）、4-8小时（OR 0.27；95%CI，0.13至0.58；<0.0008）和8-12小时（OR 0.51；95%CI，0.30至0.87；=0.01）时，阻滞组CRBD的发生率低于非阻滞组。其次，在0-1小时、1-2小时和4-8小时，阻滞组中重度CRBD的发生率低于非阻滞组，OR分别为0.12（95%CI，0.03至0.49；=0.003）、0.17（95%CI，0.08至0.37；<0.00001）和0.29（95%CI，0.15至0.55；=0.0002）。最后，阻滞组与PONV发生率降低显著相关（OR，0.14；95%CI，0.05至0.39；=0.0002）。
这项荟萃分析表明，PNB可显著降低术后早期CRBD的发生率和严重程度，并减少PONV的发生。
