超声引导下竖脊肌平面阻滞用于择期剖宫产术后镇痛的最佳方法:系统评价和荟萃分析方案。

Optimal approach to ultrasound-guided quadratus lumborum blocks for postoperative analgesia in elective caesarean section: protocol for systematic review and meta-analysis.

机构信息

Department of Anesthesiology, Northwest Women and Children's Hospital, Xi'an, China.

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.

出版信息

BMJ Open. 2024 Aug 6;14(8):e085513. doi: 10.1136/bmjopen-2024-085513.

Abstract

INTRODUCTION

Ultrasound-guided quadratus lumborum blocks are commonly used for postoperative analgesia during caesarean section. Ultrasound-guided quadratus lumborum blocks can be performed through four approaches, including lateral, posterior, anterior, and intramuscular quadratus lumborum blocks. This systematic review and meta-analysis aims to determine the optimal approach to ultrasound-guided quadratus lumborum blocks for postoperative analgesia in elective caesarean section.

METHODS AND ANALYSIS

The PubMed, EMBASE, Cochrane Library and Web of Science databases will be systematically searched from their inception to 30 July 2024. Randomised controlled trials that compared the analgesic effects of different ultrasound-guided quadratus lumborum block approaches in elective caesarean section will be included. Only publications in English will be eligible for inclusion. The total postoperative analgesic consumption over 24 hours will be the primary outcome. The time to first analgesic request, postoperative pain scores at rest and during movement, and incidence of adverse effects will be secondary outcomes. RevMan V.5.4 will be used for the statistical analysis. Network meta-analysis will be used for indirect comparisons between different approaches across studies. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to assess the quality of evidence for each outcome.

ETHICS AND DISSEMINATION

Ethical approval was not required. The results of this study will be submitted to peer-reviewed journals.

PROSPERO REGISTRATION NUMBER

CRD42024503694.

摘要

简介

超声引导下竖脊肌阻滞常用于剖宫产术后的镇痛。超声引导下竖脊肌阻滞可通过四种途径进行,包括外侧、后侧、前侧和肌间竖脊肌阻滞。本系统评价和荟萃分析旨在确定用于择期剖宫产术后镇痛的超声引导下竖脊肌阻滞的最佳方法。

方法和分析

将从建库至 2024 年 7 月 30 日系统地检索 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 数据库。将纳入比较不同超声引导下竖脊肌阻滞方法在择期剖宫产中镇痛效果的随机对照试验。只有发表在英文期刊上的文献才符合纳入标准。24 小时内的总术后镇痛消耗量将作为主要结局。首次镇痛需求时间、静息和运动时的术后疼痛评分以及不良反应发生率将作为次要结局。RevMan V.5.4 将用于统计分析。网络荟萃分析将用于研究间不同方法的间接比较。将使用推荐评估、制定与评估方法(Grading of Recommendations Assessment, Development and Evaluation approach)评估每个结局的证据质量。

伦理和传播

本研究无需伦理批准。研究结果将提交给同行评议的期刊。

PROSPERO 注册号:CRD42024503694。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc43/11308870/cba0d6efcfeb/bmjopen-14-8-g001.jpg

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