Systematic review and meta-analysis of ropivacaine use in laparoscopic hysterectomy

To assess the efficacy of all forms of ropivacaine administration for the management of pain and opioid use, specifically in patients undergoing laparoscopic hysterectomy. We searched PubMed, Cochrane CENTRAL, Web of Science, and SCOPUS for relevant clinical trials matching our eligibility criteria....

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Bibliographic Details
Published in:Turkish journal of obstetrics and gynecology 2021-03, Vol.18 (1), p.56-64
Main Authors: Marchand, Greg J, Azadi, Ali, Sainz, Katelyn, Anderson, Sienna, Ruther, Stacy, Ware, Kelly, Hopewell, Sophia, Brazil, Giovanna, King, Alexa, Cieminski, Kaitlynne, Steele, Allison, Love, Jennifer
Format: Article
Language:English
Subjects:
Abdomen
Analgesics
Bias
Clinical trials
Hysterectomy
Intervention
Kadın Hastalıkları
Laparoscopy
Meta-analysis
Narcotics
Pain
Review
Surgery
Systematic review
Tıp
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Summary:To assess the efficacy of all forms of ropivacaine administration for the management of pain and opioid use, specifically in patients undergoing laparoscopic hysterectomy. We searched PubMed, Cochrane CENTRAL, Web of Science, and SCOPUS for relevant clinical trials matching our eligibility criteria. Outcomes of interest included: Pain intensity (measured either by visual analog scale score or by numerical rating scale score), QoR-40 score (Overall quality of recovery tool, designed to measure physical comfort, physical independence, pain, emotional status, and need for support), and the need for opioid rescue. We performed the analysis under the fixed-effects model for homogeneous data and random-effects model for heterogeneous data. Most heterogeneous data were solved by the leave-one-out method, in cases where this was not successful, we then proceeded to conduct at least one subgroup meta-analysis in an attempt to solve heterogeneity. We assessed the risk of bias using Cochrane's risk of bias tool. A total of five clinical trials were included. Regarding the pain score, there was no significant difference between either group [standardized mean difference=-0.17, 95% confidence interval (CI): (-0.56, 0.23); p=0.41]. The analysis of the overall RoQ40 scores favored the ropivacaine group over the control group significantly [mean difference (MD)=17.68, 95% CI: (1.48, 33.87); p
ISSN:2149-9322
2149-9330
DOI:10.4274/tjod.galenos.2021.06606