Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Vol. 5 No. 2 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)

A Systematic Review and Meta-Analysis of Paracervical Blocks as A Perioperative Strategy in Reducing Postoperative Pain in Patients Undergoing Laparoscopic Hysterectomy

Rifaldy Nabiel (Soebandi General Hospital, Faculty of Medicine University of Jember, Jember, Indonesia)
Daniel Alexander Suseno (Department of Obstetrics and Gynecology, dr. Soebandi Regional Hospital, Faculty of Medicine, University of Jember, Jember, Indonesia)
Yonas Hadisubroto (3Department of Anaesthesia and Intensive Care, Soebandi General Hospital, Faculty of Medicine, University of Jember, Jember, Indonesia)
Taufiq Gemawan (Department of Anaesthesia and Intensive Care, Soebandi General Hospital, Faculty of Medicine, University of Jember, Jember, Indonesia)
Aurellia Nuraini Anindito Putri (Soebandi General Hospital, Faculty of Medicine, University of Jember, Jember, Indonesia)
Syadza Salsabila (Soebandi General Hospital, Faculty of Medicine, University of Jember, Jember, Indonesia)
Eprila Darma Sari (Soebandi General Hospital, Faculty of Medicine, University of Jember, Jember, Indonesia)



Article Info

Publish Date
29 Jul 2023

Abstract

Introduction: Perioperative strategies to reduce postoperative pain are important for enhancing patient satisfaction. However, further research and trials has sparked ongoing debates of various strategies regarding efficacy and safety. Objective: This study aims to improve evidence-based strategies regarding the effect of paracervical anaesthetic blocks in patients undergoing laparoscopic hysterectomy. Materials and Method: A systematic literature search was conducted through PubMed, Google Scholar, and ScienceDirect for RCTs in laparoscopic hysterectomy patients administered paracervical blocks and those given placebos. The quantitative analysis of pooled relative risk and mean difference with a 95% confidence interval were performed using the Review Manager 5.4 software in the random-effects model or fixed-effects model forest plot. Results: Based on four RCTs included in the analysis, there were significant differences in overall postoperative pain scores assessed by VAS (Visual Analogue Scale) [MD = -0.82, 95%CI (-1.47 to -1.06), p = 0.01]. The subgroup analysis also showed significant differences in VAS pain scores at 30 min and 1 hour post-operation [MD = -2.13, 95% CI (-3.09 to -1.16), p = 0.0001] and [MD = -2.55, 95% CI (-4.29 to -0.81), p = 0.004]. However, there were insignificant results in adequate pain control [RR = 7.90, 95%CI (0.39 to 158.67), p = 0.18], length of hospital stay [MD = 0.01, 95%CI (-0.52 to 0.54), p = 0.96], additional analgesics requirement at 24 hours [RR = 0.88, 95%CI (0.55 to 1.39), p=0.58], and perioperative complications [RR = 0.90, 95%CI (0.56 to 1.47), p = 0.68].Conclusion: This meta-analysis provides evidence that the administration of paracervical block in patients undergoing laparoscopic hysterectomy is associated with a reduction of postoperative VAS pain score but not associated with the length of hospital stay, adequate pain control, additional analgesics requirement at 24 hours, and perioperative complications.

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Journal Info

Abbrev

IJAR

Publisher

Subject

Medicine & Pharmacology

Description

IJAR is a scientific journal published by Department of Anesthesiology and Reanimation, Faculty of Medicine Universitas Airlangga. IJAR is an English language journal. IJAR FOCUSES original research, review article, case report, and correspondence, on anesthesiology; pain management; intensive care; ...