Table 1.
Basic characteristics of trails included.
| Study | Surgery | Patient gender | Country | Number of patients | Control | Experiment | Opioid | Dose (µg) | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Male | Female | Control | Experiment | LA | Dose (mg) | LA | Dose (mg) | ||||||
| 01 | Abdollahpour et al. 2015 | Cesarean section | 0 | 50 | Iran | 25 | 25 | Bupivacaine 0.5% | 12,5 | Bupivacaine 0.5% | 12,5 | Sufentanil | 1.5 |
| 02 | Acharya et al. 2019 | Cesarean section | 0 | 60 | Nepal | 30 | 30 | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 10 | Fentanyl | 12.5 |
| 03 | Agrawal et al. 2016 | Cesarean section | 0 | 40 | India | 20 | 20 | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 12.5 | Fentanyl | 25 |
| 04 | Akan et al. 2013 | TURP | 60 | 0 | Turkey | 20 | 20/20 | Levobupivacaine 0.5% | 10 | Levobupivacaine 0.5% | 7.5/7.5 | Fentanyl/Sufentanil | 25/2.5 |
| 05 | Asokumar et al. 1998 | Labor analgesia | 0 | 41 | United States of America | 19 | 22 | Bupivacaine 0.25% | 2.5 | Bupivacaine 0.25% | 2.5 | Fentanyl | 25 |
| 06 | Atallah et al. 2003 | Transurethral Cystoscopic Surgery | NS | NS | Egypt | 40 | 40 | Bupivacaine 0.1% | 5 | Bupivacaine 0.1% | 5 | Fentanyl | 20 |
| 07 | Atallah et al. 2006 | Percutaneous nephrolitotomy | 64 | 41 | Egypt | 54 (ITT) | 54 (ITT) | Bupivacaine 0.5% | 7.5 | Bupivacaine 0.5% | 7.5 | Fentanyl | 10 |
| 08 | Attri et al. 2015 | Infraumbilical surgeries | 83 | 17 | India | 50 | 50 | Levobupivacaine 0.5% | 10 | Levobupivacaine 0.5% | 10 | Fentanyl | 25 |
| 09 | Aydın et al. 2011 | Arthroscopic knee surgery | 25 | 25 | Turkey | 25 | 25 | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 5 | Sufentanil | 2.5 |
| 10 | Bang et al. 2012 | Cesarean section | 0 | 105 | South Korea | 35 | 35/35 | Bupivacaine 0.5% | 6.5-11 | Bupivacaine 0.5% | 6.5-11 | Sufentanil | 2.5/5 |
| 11 | Ben-David et al. 1997 | Arthroscopic knee surgery | 40 | 10 | Israel | 25 | 25 | Bupivacaine 0.5% | 5 | Bupivacaine 0.5% | 5 | Fentanyl | 10 |
| 12 | Ben-David et al. 2000 | Surgery repair of hip fracture | 2 | 18 | Israel | 10 | 10 | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 4 | Fentanyl | 20 |
| 13 | Bidikar et al. 2017 | Cesarean section | 0 | 60 | India | 30 | 30 | Levoupivacaine 0.5% | 10 | Levoupivacaine 0.5% | 7.5 | Fentanyl | 12.5 |
| 14 | Biswas et al. 2002 | Cesarean section | 0 | 40 | India | 20 | 20 | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 10 | Fentanyl | 12.5 |
| 15 | Braga et al. 2003 | Cesarean section | 0 | 80 | Brazil | 20 | 20/20/20 | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 12.5 | Sufentanil | 2.5/5/7.5 |
| 16 | Braga et al. 2012 | Cesarean section | 0 | 48 | Brazil | 24 | 24 | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 10 | Sufentanil | 5 |
| 17 | Chandra et al. 2008 | Cesarean section | 0 | 60 | India | 20 | 20/20 | Bupivacaine 0.5% | 7.5 | Bupivacaine 0.5% | 7.5 | Fentanyl/Sufentanil | 25/5 |
| 18 | Chilvers et al. 1997 | Gynecological laparoscopy | 0 | 63 | Canada | 21 | 21/21 | Lidocaine 1% | 20 | Lidocaine 1% | 20 | Fentanyl | 10/25 |
| 19 | Cowan et al. 2002 | Cesarean section | 0 | 50 | United Kingdom | 25 | 25 | Bupivacaine 0.5% | 13.75 | Bupivacaine 0.5% | 13.75 | Fentanyl | 20 |
| 20 | Dahlgren et al. 1997 | Cesarean section | 0 | 80 | Sweden | 20 | 20/20/20 | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 12.5 | Fentanyl/Sufentanyl | F10/S2.5/S5 |
| 21 | Demiraran et al. 2006 | Cesarean section | 0 | 100 | Turkey | 25 | 25/25/25 | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 12.5 | Sufentanil | 1.5/2.5/5 |
| 22 | Derakhshan et al. 2018 | Lower limb surgery | 32 | 28 | Iran | 30 | 30 | Bupivacaine 0.5% | 15 | Bupivacaine 0.5% | 15 | Sufentanil | 5 |
| 23 | Desai et al. 2019 | Femur surgery | 39 | 21 | India | 30 | 30 | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 7.5 | Fentanyl | 25 |
| 24 | Doger et al. 2014 | TURP | 20 | 0 | Nigeria | 20 | 20 | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 7.5 | Sufentanil | 5 |
| 25 | Donadoni et al. 1987 | Urological procedures | 35 | 3 | Belgium | 20 (ITT) | 20 (ITT) | Lidocaine 5% | 75 | Lidocaine 5% | 75 | Sufentanil | 5 |
| 26 | Farzi et al. 2017 | Cesarean Section | 0 | 92 | Iran | 33 (ITT) | 33 (ITT)/33(ITT) | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 12.5 | Fentanyl/Sufentanil | 25/2.5 |
| 27 | Gauchan et al. 2014 | Cesarean Section | 0 | 70 | Nepal | 35 | 35 | Bupivacaine 0.5% | 12 | Bupivacaine 0.5% | 10 | Fentanyl | 20 |
| 28 | Girgin et al. 2008 | Inguinal herniorrhaphy | 31 | 7 | Turkey | 20 (ITT) | 20 (ITT) | Levoupivacaine 0.5% | 7.5 | Levoupivacaine 0.5% | 5 | Fentanyl | 25 |
| 29 | Gupta et al. 2013 | Urological procedures | 66 | 24 | India | 30 | 30/30 | Bupivacaine 0.5% | 7.5 | Bupivacaine 0.5% | 7.5 | Fentanyl/Sufentanil | 25/10 |
| 30 | Gurbet et al. 2008 | Anorrectal surgery | 24 | 11 | Turkey | 20 (ITT) | 20 (ITT) | Bupivacaine 0.5% | 5 | Bupivacaine 0.5% | 2.5 | Fentanyl | 25 |
| 31 | Hakkim et al. 2015 | Lower abdomen, urological, and lower extremities | 55 | 45 | India | 50 | 50 | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 12.5 | Sufentanil | 5 |
| 32 | Hassani et al. 2014 | Lower Extremity Surgery | 67 | 23 | Iran | 30 | 30/30 | Bupivacaine 0.5% | 15 | Bupivacaine 0.5% | 15 | Fentanyl/Sufentanil | 25/2.5 |
| 33 | Hoda et al. 2007 | Hip fracture surgery | NS | NS | Pakistain | 30 | 30/30 | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 8/6 | Fentanyl | 20/20 |
| 34 | Hunt et al. 1989 | Cesarean section | 0 | 55 | United States of America | 9 | 6/8/7/7/6/7/5 | Bupivacaine 0.5% | 7.5-11 | Bupivacaine 0.5% | 7.5-11 | Fentanyl | 2.5/5/6.25/12.5/25/37.5/50 |
| 35 | Jain et al. 2004 | Cesarean section | 0 | 45 | India | 15 | 15/15 | Bupivacaine 0.5% | 7.5 | Bupivacaine 0.5% | 7.5 | Fentanyl | 10/20 |
| 36 | Kararmaz et al. 2003 | TURP | 40 | 0 | Turkey | 20 | 20 | Bupivacaine 0.5% | 7.5 | Bupivacaine 0.5% | 4 | Fentanyl | 25 |
| 37 | Kaur et al. 2011 | Urological procedures | 55 | 5 | India | 30 | 30 | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 7.5 | Sufentanil | 10 |
| 38 | Kezri et al. 2014 | Cesarean section | 0 | 60 | Iran | 30 | 30 | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 10 | Fentanyl | 25 |
| 39 | Korhonen et al. 2003 | Knee arthroscopy | 47 | 51 | Finland | 50 (ITT) | 50 (ITT) | Bupivacaine 0.5% | 4 | Bupivacaine 0.5% | 3 | Fentanyl | 10 |
| 40 | Kuberan et al. 2018 | Cesarean section | 0 | 36 | India | 18 (ITT) | 18 (ITT) | Bupivacaine 0.5% | 2,5 | Bupivacaine 0.5% | 2 | Fentanyl | 15 |
| 41 | Kuusniemi et al. 2000 | Urological procedures | 35 | 45 | Finland | 20 | 20/20/20 | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 10/7.5/7.5 | Fentanyl | 25/25/25 |
| 42 | Lauretti et al. 1998 | Abdominal hysterectomy | 0 | 50 | Brazil | 10 | 10/10/10 | Bupivacaine 0.5% | 15 | Bupivacaine 0.5% | 15 | Fentanyl | 25/10/25 |
| 43 | Lee et al. 2005 | Urological procedures | NS | NS | Hong Kong | 25 | 25 | Levobupivacaine 0.5% | 13 | Levobupivacaine 0.5% | 11.5 | Fentanyl | 15 |
| 44 | Lee et al. 2009 | Lower extremity surgery | 19 | 16 | Korea | 20/20 | 20 | Bupivacaine 0.5% | 10/5 | Bupivacaine 0.5% | 5 | Fentanyl | 10 |
| 45 | Lee et al. 2011 | Cesarean section | 0 | 72 | Korea | 24 | 24/24 | Bupivacaine 0.5% | 6.5-12 | Bupivacaine 0.5% | 6.5-12 | Fentanyl/Sufentanil | 20/2.5 |
| 46 | Mahajan et al. 2005 | Cesarean section | 0 | 24 | India | 12 | 12 | Bupivacaine 0.5% | 7.5 | Bupivacaine 0.5% | 7.5 | Fentanyl | 20 |
| 47 | Makwana et al. 2014 | Abdominal hysterectomy | 0 | 60 | India | 30 | 30 | Bupivacaine 0.5% | 15 | Bupivacaine 0.5% | 15 | Fentanyl | 25 |
| 48 | Martin et al. 1999 | Oocyte retrieval procedures | 0 | 78 | EUA | 40 | 38 | Lidocaine 1,5% | 45 | Lidocaine 1,5% | 45 | Fentanyl | 10 |
| 49 | Martyr et al. 2001 | Hip fractures | 9 | 33 | Australia | 25 (ITT) | 23 (ITT) | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 7.5 | Fentanyl | 20 |
| 50 | Neeta et al. 2015 | Urologic, Gynecologic, Orthopedics and general surgery | NS | NS | India | 20 | 20/20 | Bupivacaine 0.5% | 15 | Bupivacaine 0.5% | 15 | Fentanyl/Sufentanil | 25/5 |
| 51 | Ngiam et al. 1998 | Cesarean section | 0 | 60 | Singapore | 20 (ITT) | 20/20 (ITT) | Bupivacaine 0.5% | 7.5 | Bupivacaine 0.5% | 7.5 | Fentanyl/Sufentanil | 15/10 |
| 52 | Olofsson et al. 2004 | Hip fractures | NS | NS | Sweden | 25 | 25 | Bupivacaine 0.5% | 15 | Bupivacaine 0.5% | 7.5 | Sufentanil | 5 |
| 53 | Ozyilkan et al. 2013 | Cesarean section | 0 | 93 | Turkey | 31 | 31/31 | Levobupivacaine 0.5% | 2.2 ± 0.2 mL | Levobupivacaine 0.5% | 2.2 ± 0.2 mL | Fentanyl/Sufentanil | 10/2,5 |
| 54 | Palmer et al. 1995 | Cesarean section | 0 | 28 | EUA | 14 | 14 | Hyperbaric lidocaine 1,5% | 80 | Hyperbaric lidocaine 1,5% | 80 | Fentanyl | 15 |
| 55 | Rajbhandari et al. 2020 | Emergency appendectomy | 52 | 68 | Nepal | 30 | 30/30/30 | Bupivacaine 0.5% | 15 | Bupivacaine 0.5% | 15/15/15 | Fentanyl | 10/20/30 |
| 56 | Randalls et al. 1991 | Cesarean section | 0 | 48 | UK | 12 | 12/12/12 | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 12.5 | Fentanyl | 10 |
| 57 | Sadegh et al. 2012 | Cesarean section | 0 | 80 | Iran | 40 | 40 | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 12.5 | Fentanyl | 25 |
| 58 | Seewal et al. 2007 | Inguinal hernia repair | 60 | 0 | UK | 12 | 12/12/12/12 | Bupivacaine 0.5% | 11 | Bupivacaine 0.5% | 11/11/11/11 | Fentanyl | 10/20/30/50 |
| 59 | Sertoz et al. 2014 | Knee arthroscopy | 33 | 26 | Turkey | 33 (ITT) | 29 | Bupivacaine 0.5% | 5 | Bupivacaine 0.5% | 5 | Sufentanil | 2,5 |
| 60 | Seyhan et al. 2006 | Cesarean section | 0 | 45 | Turkey | 15 | 15/15 | Bupivacaine 0.5% | 9 | Bupivacaine 0.5% | 9 | Fentanyl | 10/20 |
| 61 | Shahriari et al. 2007 | Cesarean section | 0 | 40 | Iran | 20 | 20 | Lidocaine 5% | 80 | Lidocaine 5% | 80 | Fentanyl | 15 |
| 62 | Shende et al. 1998 | Cesarean section | 0 | 40 | UK | 20 | 20 | Bupivacaine 0.5% | 12.5 | Bupivacaine 0.5% | 12.5 | Fentanyl | 15 |
| 63 | Shim et al. 2018 | Anorectasl surgery | 35 | 45 | Korea | 40 | 40 | Bupivacaine 0.5% | 5 | Bupivacaine 0.5% | 5 | Fentanyl | 15 |
| 64 | Singh et al. 1995 | Genitourinary surgery | 43 | 0 | USA | 22 | 21 | Bupivacaine 0.5% | 13.5 | Bupivacaine 0.5% | 13.5 | Fentanyl | 25 |
| 65 | Sung et al. 2013 | Inguinal hernia repair | 68 | 4 | Korea | 38 (ITT) | 36 | Bupivacaine 0.5% | 14 | Bupivacaine 0.5% | 13 | Fentanyl | 10 |
| 66 | Techanivate et al. 2004 | Appendectomy | NS | NS | Thailand | 20 | 20 | Bupivacaine 0.5% | 20 | Bupivacaine 0.5% | 20 | Fentanyl | 20 |
| 67 | Tyagi et al. 2013 | Cesarean section | 0 | 90 | India | 30 | 30/30 | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 10/10 | Fentanyl | 12,5/25 |
| 68 | Unal et al. 2012 | Knee arthroscopy | 18 | 25 | Turkey | 15 | 15 (ITT)/15 (ITT) | Bupivacaine 0.5% | 4 | Bupivacaine 0.5% | 4/3 | Fentanyl | 25/25 |
| 69 | Venkata et al. 2015 | Cesarean section | 0 | 50 | India | 25 | 25 | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 7,5 | Fentanyl | 25 |
| 70 | Vyas et al. 2010 | Cesarean section | 0 | 60 | India | 30 | 30 | Bupivacaine 0.5% | 11 | Bupivacaine 0.5% | 11 | Sufentanil | 5 |
| 71 | Wang et al. 2019 | Total Hip Arthroplasty | 55 | 5 | China | 33 (ITT) | 32 (ITT) | Bupivacaine 0.5% | 10 | Bupivacaine 0.5% | 7,5 | Fentanyl | 20 |
| 72 | Walsh et al. 2003 | TURP | 30 | 0 | Ireland | 15 (ITT) | 15 (ITT) | Bupivacaine 0.5% | 15 | Bupivacaine 0.5% | 10 | Fentanyl | 25 |
| 73 | Waxler et al. 2004 | Rectal ambulatory surgery | 37 | 12 | USA | 21 | 28 | Hyperbaric lidocaine 1,5% | 15 | Hyperbaric lidocaine 5% | 50 | Sufentanil | 10 |
| 74 | Weigl et al. 2016 | Cesarean section | 0 | 59 | Poland | 30 (ITT) | 30 (ITT) | Bupivacaine 0.5% | 7.5-15 | Bupivacaine 0.5% | 7.5-15 | Fentanyl | 25 |
| 75 | Yi-chun et al. 2006 | TURP | 90 | 0 | China | 30 | 30/30 | Bupivacaine 0.5% | 15 | Bupivacaine 0.5% | 7.5/7.5 | Sufentanil | 5/7,5 |
| 76 | Zohar et al. 2007 | Transurethral procedures | 100 | 0 | Israel | 25 | 25/25/25 | Bupivacaine 0.5% | 7.5 | Bupivacaine 0.5% | 5/4/3 | Fentanyl | 20/20/20 |