Table 1.
Characteristics of the published randomized controlled trails presented with respect to type of surgery
| Authors | Country | Age Range | Gender | N | Groups | N | Modalities Studied | Pain Assessment Tool | Modalities used |
Duration of post-operative Pain studied | Rescue Analgesia |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Bhatia et al., (2014) [12] | India | 18–60 | Both | 60 | 3 | 20 | Ultrasound-guided posterior transversus abdominis plane (TAP) block with 15 mL of 0.375% ropivacaine |
VAS (Visual Analogue Scale) |
Single | 24 h | Tramadol |
| 20 | Ultrasound-guided subcostal TAP block with 15 mL of 0.375% ropivacaine | ||||||||||
| 20 | Control | ||||||||||
| Shukla et al.,(2015) [13] | India | 18–60 | Both | 120 | 3 | 40 | Intraperitoneal bupivacaine 50 ml 0.25% + 5 ml Normal saline | VAS | Single | 24 h | Diclofenac |
| 40 | Bupivacaine 50 ml 0.25% + tramadol 1 mg/kg (diluted in 5 ml NS) | ||||||||||
| 40 | Bupivacaine 50 ml 0.25% + dexmedetomidine 1 μg/kg, (diluted in 5 ml NS) | ||||||||||
| Sinha et al., (2016) [14] | India | 18–65 | Both | 60 | 2 | 30 | TAP block with 0.25% Bupivacaine | VAS | Single | 24 h | Diclofenac |
| 30 | TAP block with 0.375% Ropivacaine | ||||||||||
| Kamhawy et al., (2017) [15] | Egypt | 21–60 | Both | 46 | 2 | 23 | Unilateral subcostal TAP block | VAS | Multi | 24 h | PCA Morphine |
| 23 | Unilateral thoracic paravertebral block | ||||||||||
| Saxena et al., (2016) [16] | India | 18–70 | Both | 80 | 2 | 40 | Local anesthetic infiltration of surgical incision |
NRS (Numerical rating score) |
Multi | 24 h | Fentanyl |
| 40 | Bilateral rectus sheath and right TAP blocks | ||||||||||
| Ali et al., (2012) [17] | Pakistan | 35–65 | Both | 60 | 2 | 30 | Oral pregablin 150 mg | VAS | Single | 24 h | Nalbuphine |
| 30 | Oral celecoxib 200 mg | ||||||||||
| Suseela et al., (2018) [18] | India | 20–65 | Both | 80 | 2 | 40 | Bilateral ultrasound-guided subcostal TAP block with 20 mL of 0.25% bupivacaine | NRS | Multi | 24 h | Tramadol Diclofenac |
| 40 | Port-site infiltration with 20 mL of 0.5% bupivacaine | ||||||||||
| Anand et al.,(2017) [19] | India | 20–60 | Both | 60 | 2 | 30 | Alprazolam | VAS | Multi | 24 h | Tramadol |
| 30 | Pregabalin | ||||||||||
| Pasha et al., (2018) [20] | Nowshera | 18–65 | Both | 90 | 2 | 45 | Gabapentin | VAS | Multi | 24 h | None |
| 45 | Placebo | ||||||||||
| Khan et al., (2018) [21] | pakistan | 18–60 | Both | 126 | 2 | 63 | Posterior TAP block with 0.375% bupivacaine | NRS | Multi | 24 h | Tramadol |
| 63 | subcostal TAP block with 0.375% bupivacaine | ||||||||||
| Jain et al., (2018) [22] | India | 20–60 | Both | 60 | 2 | 30 | Intraperitoneal Saline with 500 ml | NRS | single | 24 h | Tramadol |
| 30 | Intraperitoneal Bupivacaine with 20 ml of 0.5% (100 mg) | ||||||||||
| Amr et al., (2010) [23] | Egypt | 18+ | Both | 40 | 2 | 20 | Preincisional thoracic epidural analgesia (TEA) | VAS | Single | 24 h | None |
| 20 | End of surgery TEA | ||||||||||
| Khalil et al., (2017) [24] | Egypt | 20–60 | Both | 40 | 2 | 20 | Ultrasound-guided serratus anterior plane block | VAS | Multi | 24 h | Morphine |
| 20 | TEA | ||||||||||
| Dutta et al., (2017) [25] | India | 18–70 | Both | 30 | 2 | 15 | Bolus of 15 mL of 0.75% ropivacaine over 3 to 5 min, followed by an infusion of 0.2% ropivacaine at 0.1 ml/kg/hour | VAS | Multi | 24 h | Morphine |
| 15 | 15 ml of 0.75% ropivacaine plus dexmedetomidine,1 mg/kg bolus over 3 to 5 minutesfollowed by an infusion of 0.2% ropivacaine plus 0.2 mg/kg/hour of dexmedetomidine at 0.1 ml/kg/hour. | ||||||||||
| Biswas et al., (2016) [26] | India | 18–60 | Both | 60 | 2 | 30 | Epidural: 7.5 ml bolus of 0.125% Bupivacaine with 50 μg Fentanyl | VAS/ FPORS | Muti | 24 h | Tramadol |
| 30 | Paravertebral 15 ml bolus of 0.125% Bupivacaine with 50 μg Fentanyl | ||||||||||
| Bakshi et al., (2016) [27] | India | 18–75 | Female | 71 | 2 | 36 | Rectus sheath block with 0.25% bupivacaine | NRS | Multi | 48 h | Morphine |
| 35 | Rectus sheath block with normal saline | ||||||||||
| Dhanapal et al., (2014) [28] | India | 18+ | Both | 94 | 2 | 47 | Wound infusion with Bupivacaine | VAS | Single | 48 h | Morphine |
| 47 | Wound infusion with N saline | ||||||||||
| Wahba et al., (2014) [29] | Egypt | 59–75 | Both | 44 | 2 | 22 | Thoracic epidural infusion | VRS | Multi | 48 h | Morphine (PCA) |
| 22 | Bilateral TAP block infusion with catheter | ||||||||||
| Sethi et al., (2014) [30] | India | 18–45 | Both | 100 | 2 | 50 | Patient controlled epidural analgesia (PCEA) with Ketamine + Morphine | VAS | Multiple | 48 h | Diclofenac |
| 50 | PCEA Morphine | ||||||||||
| Moawad et al., (2014) [31] | Egypt | 20–60 | Both | 100 | 2 | 50 | PCEA Bupivacaine + Fentanyl | NRS | Multiple | 24 h | Fentanyl |
| 50 | Intravenous patient controlled analgesia (PCA) with Fentanyl | ||||||||||
| Patil et al., (2018) [32] | India | 18–65 | Female | 60 | 2 | 30 |
Thoracic epidural infusion with 0.125% Ropivacaine and Fentanyl 0.125% Bupivacaine and Fentanyl |
VAS | Multi | 24 h | Tramadol |
| 30 | |||||||||||
| Bharti et al., (2018) [33] | India | Adult patients | Both | 40 | 2 | 20 | 50 μg Dexmedetomidine with 10 ml of 0.125% Bupivacaine in thoracic epidural | VAS | Multi | 24 h | Diclofenac |
| 20 | 50 μg Fentanyl with 10 ml 0.125% Bupivacaine in thoracic epidural | ||||||||||
| Alvi et al., (2017) [34] | Pakistan | 18–50 | Both | 200 | 2 | 100 | TAP block | NRS | Single | 24 h | None |
| 100 | Placebo block | ||||||||||
| Patel et al., (2018) [35] | India | 20 to 65 | Both | 60 | 2 | 30 | TAP block with Ropivacaine (0.5%) 20 ml | VAS | Multi | 24 h | Diclofenac |
| 30 | Spinal anaesthesia | ||||||||||
| Mishra et al., (2018) [36] | India | 18–60 | Both | 60 | 2 | 30 | Thoracic paravertebral block (20 mL 0.25% bupivacaine) | VAS | Multi | 24 h | Tramadol |
| 30 | IV PCA with fentanyl | ||||||||||
| Bharti et al., (2011) [37] | India | 18–60 | Both | 40 | 2 | 20 | TAP Block with 20 mL of 0.25% bupivacaine | VAS | Single | 24 h | Morphine |
| 20 | TAP Block with Saline | ||||||||||
| Chotton et al., (2014) [38] | India | 18–60 | Female | 90 | 2 | 45 | Pregabalin 150 mg | VAS | Multi | 24 h | Ketorolac |
| 45 | Placebo | ||||||||||
| Badawy et al., (2015) [39] | Egypt | 40–70 | Female | 60 | 3 |
20 20 20 |
Oral gabapentin 800 mg Gabapentin 800 mg + Dexamethasone 8 mg Placebo |
VAS | Multi | 24 h | Meperidine |
| Bashandy et al., (2015) [40] | Egypt | Adult | Female | 120 | 2 |
60 60 |
Ultrasound-guided Pecs block Control |
VAS | Single | 24 h | Morphine |
| Hetta et al., (2016) [41] | Egypt | Adult | Female | 111 | 4 |
28 27 26 30 |
Pregabalin 75 mg Pregabalin 150 mg Pregabalin 300 mg Placebo Capsule |
VAS | Single | 24 h | Morphine |
| Kasimahanti et al.,(2016) [42] | India | 18–60 | Female | 58 | 2 |
28 30 |
Single-level, unilateral ultrasound-guided TPVB at T4 level using 0.3 mL/kg of 0.5% ropivacaine Double-level, unilateral ultrasound-guided TPVB at T2 and T5 level using a total volume of 0.3 mL/kg of 0.5% ropivacaine |
NRS | Single | 24 h | Diclofenac |
| Kulhari et al., (2016) [43] | India | 18–65 | Female | 40 | 2 | 20 | TPVB with ropivacaine 0.5%, 25 ml, | VAS | Single | 24 h | Morphine |
| 20 | PECS II block with ropivacaine 0.5% | ||||||||||
| Gupta et al., (2017) [44] | India | 18–65 | Female | 50 | 2 | 25 | Paravertebral block | VAS | Multi | 72 h | PCA Morphine |
| 25 | Serratus Plane block | ||||||||||
| Bhuvaneswari et al.,(2012) [45] | India | Adult | Female | 48 | 4 | 12 | Paravertebral block with 0.25% bupivacaine with epinephrine 5 mcg/ ml | VAS | Single | 24 h | Morphine |
| 12 | Paravertebral block with 0.25% bupivacaine + epinephrine 5 mcg/ml with 2 mcg/ml fentanyl | ||||||||||
| 12 | Paravertebral block with 0.5% bupivacaine + epinephrine 5 mcg/ml or isotonic saline | ||||||||||
| 12 | Noraml Salin | ||||||||||
| Mahran et al., (2015) [46] | Egypt | 18–65 | Female | 90 | 3 | 30 | Pregabalin 150 mg oral | VAS | Multi | 24 h | Morphine |
| 30 | Placebo capsule (oral) and 0.5 mg/kg ketamine IV | ||||||||||
| 30 | Placebo | ||||||||||
| Kundra et al., (2013) [47] | India | Adult | Female | 120 | 2 | 60 | Paravertebral block | VAS | Multi | 24 h | No rescue analgesia |
| 60 | Interpleural block | ||||||||||
| M. Neetu et al., (2018) [48] | India | 18–70 | Female | 60 | 2 | 30 | PECS block | VAS | Multi | 24 h | None |
| 30 | Placebo | ||||||||||
| Mukherjee et al., (2018) [49] | India | 35–60 | female | 88 | 2 | 44 | Ropivacaine (0.5%) | VAS | single | 48 h | Diclofenac |
| 44 | Dexmedetomidine 1 μ/kg | ||||||||||
| Megha et al., (2018) [50] | India | 18–60 | Female | 47 | 2 | 23 | Paravertebral block with 20 ml bupivacaine 0.25% with morphine 3 mg | NRS | Multi | 24 h | Diclofenac |
| 24 | Dexmedetomidine 1 μg/kg | ||||||||||
| Manzoor et al., (2018) [51] | India | 18–70 | Female | 60 | 2 | 30 | PECS I block with 30 ml 0.25% bupivacaine | VAS | single | 24 h | Diclofenac |
| 30 | PECS I block with 10 ml 0.25% bupivacaine with dexmedetomidine | ||||||||||
| Kumar et al., (2018) [52] | India | ? | Female | 50 | 2 | 25 | Opioids and non-steroidal anti-inflammatory drug | VAS | Multi | 24 h | Tramadol |
| 25 | PECS I with 0.25% bupivacaine | ||||||||||
| Bharti et al., (2015) [53] | India | 20–60 | Both | 54 | 2 | 27 | Supraclavicular block with 1 μg/kg of Dexmedetomidine along with equal volumes of 0.75% ropivacaine and 2% lidocaine with adrenaline. | VAS | Single | 24 h | Tramadol Diclofenac |
| 27 | 0.75% Ropivacaine and 2% Lidocaine with adrenaline (1:2,00,000) | ||||||||||
| Kumar et al., (2014) [54] | India | 18–60 | Both | 30 | 2 | 15 | Ultrasound-guided stellate ganglion block with 2% Lidocaine | VAS | Single | 24 h | PCIA Used [No Rescue] |
| 15 | Ultrasound-guided stellate ganglion block with 0.9% Saline | ||||||||||
| Mullaji et al., (2010) [55] | India | 50–80 | Both | 40 | 2 | 20 | Combined spinal epidural + local anesthetic infiltration | VAS | Single | 24 h | None |
| 20 | Combined spinal epidural with no local anesthetic infiltration | ||||||||||
| Khanna et al., (2017) [56] | India | 40–60 | Both | 90 | 3 | 30 | Epidural with ropivacaine 0.1% | VAS | Multi | 36 h | PCEA |
| 30 | Epidural with ropivacaine 0.1% with fentanyl 2.5μg/mL | ||||||||||
| 30 | Epidural with ropivacaine 0.0625% with fentanyl 2.5μg/mL | ||||||||||
| Anis et al., (2011) [57] | Egypt | 18–60 | Both | 60 | 3 | 20 | Lumbar plexus block with 15 ml bupivacaine 0.25% + clonidine | VAS | Single | 24 h | Morphine |
| 20 | Lumbar plexus block with bupivacaine 0.25% + clonidine | ||||||||||
| 20 | No Block | ||||||||||
| Sawhney et al., (2015) [58] | India | Adult | Both | 100 | 4 | 25 | Epidural with 0.2% Ropivacaine | VAS | Single | 24 h | Tramadol |
| 25 | Epidural with0.1% Ropivacaine+Fentanyl 2 μg/ml | ||||||||||
| 25 | Epidural with 0.2% Bupivacaine | ||||||||||
| 25 | Epidural with Bupivacaine 0.1% with Fentanyl 2 μg/ml. | ||||||||||
| Trabelsi et al., (2017) [59] | Tunisia | > 18 | Both | 60 | 2 | 30 | Suprascapular block + supraclavicular block | VAS | Multi | 24 h | Morphine |
| 30 | Interscalene block | ||||||||||
| Meghana et al., (2017) [60] | India | 20–65 | Both | 70 | 2 | 35 | 0.125% bupivacaine and 2 mg/ml fentanyl epidural infusion | NRS | Single | 48 h | Tramadol |
| 35 | 0.2% ropivacaine and 2 mg/ml fentanyl as epidural infusion | ||||||||||
| Thakur et al., (2015) [61] | India | 18–60 | Both | 67 | 3 | 22 | Axillary brachial plexus block with bupivacine, lignocaine, adrenaline and buprenorphine + IM placebo | VAS | Single | 24 h | Diclofenac |
| 23 | Axillary brachial plexus block with bupivacine, lignocaine, adrenaline and placebo + IM buprenorphine | ||||||||||
| 22 | Axillary brachial plexus block with bupivacine, lignocaine, adrenaline and placebo + IM placebo | ||||||||||
| Mostafa et al., (2018) [62] | Egypt | 50–70 | Both | 60 | 2 | 30 | Levobupivacaine 0.125% | VAS | Multi | 24 h | None |
| 30 | IV fentanyl 20 μg/ml |