Effect of thoracic paravertebral nerve block on postoperative analgesia in patients undergoing CABG under general anesthesia: a meta-analysis
10.3760/cma.j.cn131073.20240206.00413
- VernacularTitle:TPVB对全身麻醉下CABG患者术后镇痛效果的影响：meta分析
- Author:
Ning XU
1
;
Mingchao BI
;
Wei RONG
Author Information
1. 青岛大学附属威海市中心医院麻醉科，威海 264400
- Keywords:
Nerve block;
Thoracic vertebrae;
Anesthesia, general;
Coronary artery bypass;
Analgesia, patient-controlled;
Meta-analysis
- From:
Chinese Journal of Anesthesiology
2024;44(4):447-453
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To systematically review the effect of bilateral thoracic paravertebral nerve block (TPVB) on postoperative analgesia in the patients undergoing coronary artery bypass grafting (CABG) under general anesthesia (GA) using a meta-analysis.Methods:A systematic search of PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang, and VIP databases was performed, with a limited search period ending in December 2023. Randomized controlled trials regarding bilateral TPVB combined with GA versus GA alone for postoperative analgesia following CABG were included. The primary outcome was the rate of 24 h postoperative rescue analgesia. Secondary outcomes were intraoperative opioid consumption, incidence of intraoperative adverse reactions, indicators related to postoperative recovery, and incidence of postoperative adverse reactions. This meta-analysis was performed by using the " meta" package in R studio software.Results:A total of 9 papers ( n=788) were included. Compared to GA, bilateral TPVB combined with GA reduced intraoperative opioid consumption ( SMD=-1.88, 95% confidence interval [ CI] -2.80--0.96), decreased the rate of 24 h postoperative rescue analgesia ( RR=0.17, 95% CI 0.06-0.46) and the incidence of postoperative adverse reactions ( RR=0.39, 95% CI 0.25-0.60) and shortened postoperative extubation time ( MD=-1.52, 95% CI -2.01--1.03), postoperative intensive care unit stay ( MD=-4.40, 95% CI -5.29--3.51) and postoperative hospitalization time ( MD=-0.70, 95% CI -1.37--0.04). Conclusions:Bilateral TPVB can enhance the postoperative analgesic effect in the patients undergoing CABG under general anesthesia.
