Table 1.
Summary of included studies
| Author | Year | Procedure | USG | Number treatment/ control | Block/intervention | Outcomes | Block complications | Modified Jadad score (1–5) |
|---|---|---|---|---|---|---|---|---|
| Ince et al27 | 2017 | Arm/forearm/hand surgery | Y | 30/30 | Infraclavicular brachial plexus block | Pain score: no difference | None | 4 |
| Litz et al28 | 2017 | Umbilical hernia repair | Y | 30/31 | Percutaneous rectus sheath block Intraoperative rectus sheath block | Pain score: no difference in PACU Analgesic use: no difference in PACU | None | 3 |
| Luo et al29 | 2017 | Pectus excavatum surgery | Y | 34/28 | Bilateral intercostal nerve block IVPCA | Pain score: less in block group first 6 hours Analgesic use: higher in IVPCA group at 24 hours | None | 4 |
| Marjanovic et al30 | 2017 | Orchiopexy/inguinal hernia repair | Y | 13/10/17 | Caudal block | Analgesic use: no difference | None | 2 |
| Ozkan et al31 | 2017 | Soft tissue release for knee/ankle flexion contracture | Y | 27/27 | Popliteal block | Pain score: less in the popliteal group | None | 5 |
| Park el al32 | 2017 | Orthopedic lower extremity surgery | Y | 30/30 | PCA+dexmedetomidine PCA+fentanyl | Pain score: less in dexmedetomidine group at 6 hours Analgesic use: no difference | Neurologic deficit | 5 |
| Raof et al33 | 2017 | Hernia repair/ hydrocelectomy | Y | 30/30 | TAP block dexmedetomidine | Analgesic use: lower in the dexmedetomidine group | None | 5 |
| Sahin et al34 | 2017 | Lower abdominal surgery | Y | 30/30/30 | TAP block Ilioinguinal/iliohypogastric blocks Caudal block | Pain score: lower in the TAP and caudal groups at 8 hours Analgesic use: less in TAP and caudal groups | None | 1 |
| Sharara-Chami et al35 | 2017 | Circumcision | Y | 20/20/20/10 | Dorsal penile nerve block Ring block local anesthetic cream+sucrose | Pain score: lower scores in the intervention group. Analgesia: longer in the ring block group/ sucrose/cream | None | 5 |
| Uchinami et al36 | 2017 | Laparoscopic percutaneous extraperitoneal closure | Y | 17/17 | Rectus sheath block Local anesthetic infiltration | Pain score: no difference at 30 or 60 m | None | 3 |
| Abd-Elshafy et al37 | 2016 | Lower extremity orthopedic surgery | N | 30/30/30 | Caudal block IV dexamethasone Caudal dexamethasone | Time to first analgesia and number of patients requiring rescue analgesics were less in the IV dexamethasone and caudal dexmedetomidine groups | None | 4 |
| Abu Elyazed et al38 | 2016 | Open inguinal hernia repair | Y | 30/30 | TAP block | Pain score: lower in TAP block group at 12 hours analgesia use: higher in GA group | None | 2 |
| Anouar et al39 | 2016 | Circumcision | N | 20/20 | Dorsal penile nerve block Clonidine | Pain scale: lower in clonidine group at 2 to 24 hours Analgesic use: less in clonidine group at 24 hours | None | 3 |
| Jarraya et al40 | 2016 | Hernia repair Orchiopexy | N | 20/20 | Caudal block with clonidine+fentanyl Caudal block with fentanyl+placebo | Pain score: less in clonidine group after 6 hours | Residual motor blockade in clonidine group | 3 |
| Kendigelen et al41 | 2016 | Inguinal hernia | Y | 20/20 | TAP block Wound infiltration | Pain score: lower in the TAP group Analgesia use: higher at fifth minutes, 1, 6, and 12 hours in the WI group | None | 2 |
| Kendigelen et al42 | 2016 | Hypospadias | N | 41/40 | Pudendal nerve block Caudal block | Pain score: less in the pudendal group at 24 hours Analgesia use: more in the caudal group | None | 5 |
| Marinkovic et al43 | 2016 | Knee arthroscopy | Y | 30/30 | Femoral and obturator nerve blocks General anesthesia | Pain score: lower in the block group at 2, 6, and 12 hours Analgesia use: less in the block group | None | 2 |
| Niiyama et al44 | 2016 | Microtia surgery | N | 24/26 | Intercostal nerve block Continuous wound infiltration | Pain control: less in WI group at 12, 36, 48, 60, and 72 hours Analgesia use: less in WI group | None | 2 |
| Ohashi et al45 | 2016 | Inguinal hernia repair | Y | 19/20 | Ilioinguinal/iliohypogastric nerve block | Pain score: no difference at 30 m, 1 hour, 4 hours Analgesic use: not reported | None | 5 |
| Sethi et al46 | 2016 | Lower abdominal surgery | Y | 36/34 | Caudal block TAP block | Pain control: up to 6 hours no difference; was less in TAP block group 6–24 hours Rescue analgesia: no difference | Not reported | 3 |
| Shank et al47 | 2016 | Burn reconstructive surgery | Y | 5/7/7 | Local analgesia infiltration LFCN block FIC block+continuous infusion | Pain score: less in single shot block and catheter group during first 24 hours. Analgesia use: no difference | Not reported | 2 |
| Soaida et al48 | 2016 | Renal transplant | N | 30/30 | Epidural group+multimodal regimen Multimodal regimen | Pain control: was better in epidural group | None | 2 |
| Woo et al49 | 2016 | Microtia surgery | Y | 30/29 | Intercostal nerve block+catheter-based infusion/IV analgesia | Pain score: less in ICNB group in chest at rest Rescue analgesia use: less in the ICNB group | None | 3 |
| Arbi et al50 | 2015 | Open unilateral herniotomy | N | 32/32 | Caudal IV dexamethasone caudal block | Pain score: less in IV dexmedetomidine group on POD 1 and 2. | None | 4 |
| Al-Zaben et al51 | 2015 | Lower abdominal and perineal surgery | N | 31/30/30 | Caudal bupivacaine Caudal bupivacaine + 1μg/kg dexmedetomidine Caudal bupivacaine + 2μg/kg dexmedetomidine | Pain score: less in dexmedetomidine groups at 24 hours Analgesic first use: higher in the non- dexmedetomidine group at 24 hours | None | 5 |
| Bryskin et al52 | 2015 | Bilateral ureteral reimplantation | Y | 24/21 | TAP block Caudal group | Pain scores: lower in the caudal group at PACU Analgesic use: lower in the TAP block group at 24 hours | None | 5 |
| Hamill et al53 | 2015 | Appendectomy | Y | 73/73 | Rectus sheath block | Pain scores: less in block group at 3 hours Analgesic use: no difference | None | 5 |
| Lapmahapaisan et al54 | 2015 | Non-laparoscopic major abdominal surgery | Y | 18/18/18 | TAP block Local anesthetic infiltration Placebo | Pain score: no difference Analgesic use: no difference | None | 5 |
| Lundblad et al55 | 2015 | Inguinal hernia repair | Y | 21/22 | Ilioinguinal/iliohypogastric nerve block with/without dexmedetomidine | Pain score: lower in the dexmedetomidine group at PACU Analgesic first use: prolonged in dexmedetomidine group but no difference | None | 5 |
| Suresh et al56 | 2015 | Lower abdominal surgery | Y | 18/18 | TAP block with bupivacaine 2.5 mg/kg/1.25 mg/kg | Pain scores: no difference Analgesic use: higher in the lower dose group | None | 5 |
| Tuzcu et al57 | 2015 | Strabismus | N | 20/20 | Sub-Tenon’s block | Pain scores: less in block group at 30 m Analgesic use: less in block group | None | 3 |
| Visoiu et al58 | 2015 | Cholecystectomy | N | 41/42 | Paravertebral block Port infiltration | Pain score: no difference Analgesic use: no difference | None | 5 |
| Al-Zaben et al59 | 2014 | Unilateral orchiopexy | N | 35/35 | Ilioinguinal/iliohypogastric nerve block IV morphine | Pain scores: lower in morphine group at 1 hour Analgesic use: no difference at 24 hours | None | 3 |
| Bharti et al60 | 2014 | Lower abdominal and perineal surgeries | N | 20/19/20/19 | Caudal block dexmedetomidine (0.5/1.0/1.5 μg/kg) | Pain scores: higher in the plain ropivacaine group at 3–5 hours Analgesic use: more in the plain ropivacaine group | None | 5 |
| Chiono et al61 | 2014 | Cleft palate repair | Y | 30/30 | Bilateral suprazygomatic maxillary nerve block | Pain scores: no difference Analgesic use: less in the block group at 48 hours | Bleeding at puncture site; cheek hematoma | 5 |
| Flack et al62 | 2014 | Umbilical hernia repair | Y | 20/20 | Rectus sheath block Wound infiltration | Pain scores: no difference Analgesic use: less in the block group | None | 3 |
| Kim et al63 | 2014 | Orchiopexy | Y | 40/40 | Caudal block with/without dexamethasone | Pain scores: less in dexamethasone group at 6 hours and 24 hours Analgesic use: less in dexamethasone group | None | 5 |
| Seyedhejazi et al64 | 2014 | Inguinal hernia repair, orchiopexy, hydrocelectomy | N | 33/33 | Ilioinguinal/iliohypogastric nerve block Caudal block | Pain scores: more severe in the II/IH group. Analgesic use: no difference | None | 2 |
| Qi et al65 | 2014 | Pectus excavatum | Y | 15/15 | Bilateral thoracic paravertebral block+IVPCA IVPCA | Pain scores: less in the BTPB group at 48 hours Sufentanil use: less in the BTPB group at 24 hours | None | 2 |
| Naja et al66 | 2013 | Hypospadias | Y | 40/40 | Pudendal nerve block Caudal block | Pain scores: lower in the nerve block group at 24 hours Analgesic use: higher in the caudal group at 24 hours | None | 4 |
Abbreviations: BTPB, bilateral thoracic paravertebral block; FIC, Fascia iliaca compartment; GA, general anesthesia; ICNB, intercostal nerve block; Il/IH, ilioinguinal/iliohypogastric; IV, intravenous; IVPCA, intravenous patient-controlled analgesia; LFCN, lateral femoral cutaneous nerve; PACU, post-anesthesia care unit; PCA, patient-controlled analgesia; POD, postoperative day; TAP, transverse abdominis plane; USG, ultrasound guidance; WI, surgical site local anesthetic infiltration.