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Most effective pain‐control procedure for open liver surgery: a network meta‐analysis
Author(s) -
Zhou Ling,
Huang Jian,
Chen Changwang
Publication year - 2018
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.14456
Subject(s) - medicine , cochrane library , meta analysis , randomized controlled trial , pain control , medline , anesthesia , surgery , political science , law
Background To determine the most effective pain‐control procedure for open liver surgery through a network meta‐analysis and provide a best developing direction in this field. Methods PubMed, Embase and Cochrane Library database were searched for randomized controlled trials up to 1 July 2016. We extracted data on post‐operative pain score at the 4th–8th hour and 24th hour from studies that compared various pain‐control strategies. Network meta‐analysis was conducted in Aggregate Data Drug Information System software by evaluating the parametric pain score at rest and on movement. Cumulative probability value was utilized to rank the procedures under examination. The inconsistency would also be tested by node‐splitting models. Results Twelve articles containing 661 patients were included. Intrathecal analgesia plus intravenous analgesia played the most effective role in pain controlling at post‐operative 4–8 h (both at rest and on movement, P = 0.49 and P = 0.62, respectively) and at post‐operative 24 h (both at rest and on movement, P = 0.46 and P = 0.29, respectively). Node‐splitting models test revealed that no significant inconsistency existed in this research. Conclusions Intrathecal analgesia plus intravenous analgesia revealed the most effective clinical pain‐control value for open liver surgery. More importantly, we believed that creating a better comprehensive and systematic combined pain‐control procedure should be considered as the developing direction in this field.