Table 1. Table of surgeries, interventions, timing and outcomes by subgroup of pooled studies.
An overview of the surgeries, interventions employed, the timing and the outcomes observed is provided by surgical subgroup in this table. We were able to pool study data for the subgroups of thoracotomy, breast cancer surgery, hysterectomy, ICBG, cesarean section, and prostatectomy. The majority of studies investigated epidural analgesia for thoracotomy, but for breast surgery the regional anesthesia interventions were more varied, with four studies investigating paravertebral blocks and several studies using local infiltration and even including intravenous infusions. Three of the studies on ICBG used wound instillation and intravenous infusions, while for cesarean section transverse abdominal plain block was the most frequently employed technique. (Footnotes VAS: Visual Analogue Scale, VRS: Verbal Rating Scale, DN4: DN4 questionnaire, NRS: Numerical Rating Scale, SF-36: Short Form 36)
STUDY ID | REGIONAL TECHNIQUE | TIMING OF INTERVENTION | ADJUVANTS | OUTCOME | CONTINUOUS | FOLLOW-UP |
---|---|---|---|---|---|---|
BREAST CANCER SURGERY | ||||||
ALBI- FELDZER 2013 | Infiltration and intervertebral block | Postincision, single shot vs placebo | None | Pain/no pain | Brief Pain Index | 3, 6 and 12 months |
BAUDRY 2008 | Local Infiltration | Single shot, postincision vs control | None | Pain/no pain | McGill results not reported | 18 months |
BESIC 2014 | Local Infiltration | Postincision, continuous post-op vs control | None | Pain/no pain | None | 3 months |
FASSOULAKI 2000 | Topical application | Preincision, continuous post-op vs placebo | Propoxyphene | Pain/no pain | Verbal Intensity Scale | 3 months |
FASSOULAKI 2001 | Brachial plexus block | Postincision, single shot vs placebo | Mexiletine, propoxyphene | Pain/no pain | VAS | 3 months |
FASSOULAKI 2005 | Topical application | Postincision, continuous postop vs control | Gabapentin | Pain/no pain | Analgesic consumption | 6 months |
GACIO 2016 | Paravertebral block | Single shot, preincision vs control | Parecoxib, opioid and adrenaline | Pain/no pain | None | 6 months |
GRIGORAS 2012 | IV lidocaine | Preincision, continuous intra-op vs placebo | None | Pain/no pain | Short-form McGill Pain Questionnaire | 3 months |
IBARRA 2011 | Single shot, paravertebral block | Single shot, preincision vs control | None | Phantom or neuropathic pain | None | 3 and 5 months |
KAIRALUOMA 2006 | Single shot, paravertebral block | Single shot, preincision vs control | None | NRS > 3 | Analgesic consumption | 12 months |
KARMAKAR 2014 | Thoracic paravertebral block | Single shot, pre vs post, continuous vs control | Epinephrine | Pain/no pain | VRS | 3 and 6 months |
LAM 2015 | Paravertebral block | Not specified | None | Pain/no pain | None | 6 months |
LEE 2013 | Paravertebral block | Preincision, continuous intra-op and post-op vs control | Pregabalin | Pain/no pain | Short-form McGill Pain Questionnaire | 3 months |
MICHA 2012 | Local infiltration with brachial plexus | Postincision, single shot vs placebo | None | DN4 | None | 6 months |
STRAZISAR 2012 | Local infiltration | Postincision, continuous post-op vs control | None | Pain/no pain | None | 3 months |
STRAZISAR 2014 | Local infiltration | Postincision, continuous post-op vs control | None | Pain/no pain | None | 3 months |
TECIRLI 2014 | Intercostal nerve block | Postincision, single shot vs control | None | DN4 | VAS | 3 months |
TERKAWI 2015B | IV lidocaine | Preincision, continuous intra-op and post-op vs placebo | None | Pain/no pain | VAS | 6 months |
CESAREAN SECTION | ||||||
BOLLAG 2012 | Transversus abdominis plane block | Single shot, post-op vs placebo | Clonidine | None | Short form McGill Pain Questionnaire | 3, 6 and 12 months |
LAVAND’HOM ME 2007 | Wound irrigation | Preincision, continuous post-op vs control | None | Pain/no pain | Analgesic consumption | 6 months |
LOANE 2012 | Transversus abdominis plane block | Postincision, single shot vs placebo | None | Pain/no pain | None | 3 months |
MCKEEN 2014 | Transversus abdominis plane block | Postincision, single shot vs placebo | None | None | SF-36 | 6 months |
SHAHIN 2010 | Peritoneal instillation | Postincision, single shot vs placebo | None | Pain/no pain | NRS | 8 months |
SINGH 2013 | Transversus abdominis plane block | Postincision, single shot vs placebo | None | None | NRS | 3 months |
ILIAC CREST BONE GRAFT | ||||||
BARKHUYSEN 2010 | Local Infiltration | Postincision, single shot vs control | Epinephrine | Pain/no pain | None | 1 Year |
GUNDES 2000 | Wound Instillation | Postincision, single shot vs placebo | None | Pain and dysesthesia vs none | None | 3 months |
SINGH 2007 | Wound Irrigation | Postincision, continuous post-op vs control | None | Pain/no pain | VAS, activity, Satisfaction | 4.7 years |
PROSTATECTOMY | ||||||
BROWN 2004 | Spinal | Preincision, continuous intra-op vs placebo | Clonidine | Pain/no pain | Numerical Pain Scale, SF-36 | 3 months |
GUPTA 2006 | Epidural | Continuous, post-op vs placebo | Adrenaline | None | SF-36 | 3 months |
THORACATOMY | ||||||
CAN 2013 | Epidural | Single shot, pre vs postincision, continuous vs control | None | Pain/no pain | VAS, patient Satisfaction | 6 months |
COMEZ 2015 | Epidural | Preincision, continuous intra-op vs control | Dexketoprofe, morphine, and fentanyl | Pain/no pain | VAS | 3 and 6 months |
JU 2008 | Epidural | Preincision and post-op vs control | None | Pain/no pain | Allodynia | 12 months |
KATZ 1996 | Intercostal nerve block | Single shot, postincision vs control | None | Pain/no pain | VRS, analgesic Consumption | 18 months |
LIU 2015 | Wound Irrigation | Postincision, continuous post-op vs control | Fentanyl | Pain/no pain | None | 3 months |
LU 2008 | Epidural | Preincision vs post-op vs control | None | Pain/no pain | None | 6 months |
SENTURK 2002 | Epidural | Preincision vs post-op vs control | None | Pain/no pain | NRS, pain affecting living | 6 months |
VAGINAL HYSTERECTOMY | ||||||
PURWAR 2015 | Spinal | Single shot, preincision vs control | Fentanyl | None | VAS, SF-36 | 3 months |
SPRUNG 2006 | Spinal | Single shot, preincision vs control | Clonidine | None | NRS, SF-36 | 3 months |
ABDOMINAL HYSTERECTOMY | ||||||
WODLIN 2011 | Spinal | Single shot, preincision vs control | None | None | SF-36 | 6 months |