Zhang Yu, Fu Chen, Junxia Wang, Yang Lei, Qin Zhijun
Department of Anesthesiology, Sichuan Province Orthopedic Hospital, Chengdu, Sichuan, China.
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
BMJ Open. 2024 Dec 20;14(12):e089194. doi: 10.1136/bmjopen-2024-089194.
Alleviating postoperative pain from developmental dysplasia of the hip (DDH) surgery is beneficial for paediatric patients. The most commonly used anaesthetic approach currently is general anaesthesia combined with regional nerve blocks. Existing research primarily focuses on studies comparing regional nerve blocks with placebo controls, or studies comparing two different regional nerve blocking techniques. However, the conclusions from these studies offer limited assistance to clinicians in selecting the safest and most effective nerve block. Therefore, we plan to conduct a systematic review and network meta-analysis to compare the efficacy and safety of different regional nerve blocks in managing postoperative pain in children undergoing surgery for DDH.
We will systematically search the following databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials via Ovid, as well as the Chinese databases CNKI and Wanfang. We will comprehensively search from the inception of each database to April 2024 and will include randomised controlled trials without restrictions on language or publication status. The primary outcome are postoperative pain scores at 4 hours following surgery. The quality of all included trials will be assessed using version 2 of the Cochrane Randomised Trial Risk of Bias Tool. We will employ the GeMTC package in R software for both direct and indirect comparisons within a Bayesian framework using a random effects model. Additionally, the Confidence in Network Meta-Analysis method will be employed to assess the quality of evidence.
Ethical approval is not required for this study, as it exclusively involves the compilation of published data. We plan to submit our review to academic conferences and peer-reviewed scholarly journals.
CRD42024527459.
减轻发育性髋关节发育不良（DDH）手术的术后疼痛对儿科患者有益。目前最常用的麻醉方法是全身麻醉联合区域神经阻滞。现有研究主要集中在比较区域神经阻滞与安慰剂对照的研究，或比较两种不同区域神经阻滞技术的研究。然而，这些研究的结论对临床医生选择最安全、最有效的神经阻滞帮助有限。因此，我们计划进行一项系统评价和网状Meta分析，以比较不同区域神经阻滞在DDH手术儿童术后疼痛管理中的疗效和安全性。
我们将系统检索以下数据库：MEDLINE、Embase、通过Ovid检索的Cochrane对照试验中央注册库，以及中国数据库知网和万方。我们将从每个数据库创建之初全面检索至2024年4月，并将纳入不受语言或发表状态限制的随机对照试验。主要结局是术后4小时的术后疼痛评分。所有纳入试验的质量将使用Cochrane随机试验偏倚风险工具第2版进行评估。我们将在贝叶斯框架内使用随机效应模型，在R软件中使用GeMTC软件包进行直接和间接比较。此外，将采用网状Meta分析的证据置信度方法评估证据质量。
本研究无需伦理批准，因为它仅涉及已发表数据的汇编。我们计划将我们的综述提交给学术会议和同行评审的学术期刊。
PROSPERO注册号：CRD42024527459。
