Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis
Objective To evaluate the analgesic efficacy and safety of paravertebral block (PVB) versus intercostal nerve block (INB) in thoracic surgery and breast surgery. Methods The PubMed, Web of Science, Embase and the Cochrane Library were searched up to February 2020 for all available randomized control...
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| description | Objective To evaluate the analgesic efficacy and safety of paravertebral block (PVB) versus intercostal nerve block (INB) in thoracic surgery and breast surgery. Methods The PubMed, Web of Science, Embase and the Cochrane Library were searched up to February 2020 for all available randomized controlled trials (RCTs) that evaluated the analgesic efficacy and safety of PVB compared with INB after thoracic surgery and breast surgery. For binary variables, odds ratio (OR) and 95% confidence interval (CI) was used. For continuous variables, weighted mean difference (WMD) and 95% confidence interval (CI) were used. RevMan5. 3 and Stata/MP 14.0 were used for performing the meta-analysis. Results A total of 9 trials including 440 patients (PVB block:222 patients; INB: 218 patients) met the inclusion criteria. In the primary outcome, there was no significant differences between the two groups with respect to postoperative visual analogue scale (VAS) at 1h (Std. MD = -0. 20; 95% CI = -1. 11to 0. 71; P = 0. 66), 2h (Std. MD = -0. 71; 95% CI = -2. 32to 0. 91; P = 0. 39), 24h (Std. MD = -0. 36; 95% CI = -0. 73 to -0. 00; P = 0. 05) and 48h (Std. MD = -0. 04; 95% CI = -0. 20 to 0. 11; P = 0. 57). However, there was significant difference in VAS of non Chinese subgroup at 1h (Std. MD = 0. 33; 95% CI = 0. 25to 0. 41; P |
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Methods The PubMed, Web of Science, Embase and the Cochrane Library were searched up to February 2020 for all available randomized controlled trials (RCTs) that evaluated the analgesic efficacy and safety of PVB compared with INB after thoracic surgery and breast surgery. For binary variables, odds ratio (OR) and 95% confidence interval (CI) was used. For continuous variables, weighted mean difference (WMD) and 95% confidence interval (CI) were used. RevMan5. 3 and Stata/MP 14.0 were used for performing the meta-analysis. Results A total of 9 trials including 440 patients (PVB block:222 patients; INB: 218 patients) met the inclusion criteria. In the primary outcome, there was no significant differences between the two groups with respect to postoperative visual analogue scale (VAS) at 1h (Std. MD = -0. 20; 95% CI = -1. 11to 0. 71; P = 0. 66), 2h (Std. MD = -0. 71; 95% CI = -2. 32to 0. 91; P = 0. 39), 24h (Std. MD = -0. 36; 95% CI = -0. 73 to -0. 00; P = 0. 05) and 48h (Std. MD = -0. 04; 95% CI = -0. 20 to 0. 11; P = 0. 57). However, there was significant difference in VAS of non Chinese subgroup at 1h (Std. MD = 0. 33; 95% CI = 0. 25to 0. 41; P<0. 00001) and VAS of Chinese subgroup at 24h (Std. MD = -0.32; 95% CI = -0.49 to-0.14; P = 0.0003). In the secondary outcome, the analysis also showed no significant difference between the groups according to the rates of postoperative nausea and vomit (OR = 0. 63; 95% CI = 0. 38 to 1. 03; P = 0. 06) and the rates of postoperative additional analgesia (OR = 0. 57; 95% CI = 0. 21 to 1. 55; P = 0. 27). There was significant difference in postoperative consumption of morphine (Std. MD = -14. 57; 95% CI = -26. 63 to -0.25; P = 0. 02). Conclusion Compared with INB, PVB can provide better analgesia efficacy and cause lower consumption of morphine after thoracic surgery and breast surgery.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0237363</identifier><identifier>PMID: 33017425</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Analgesia ; Anesthesiology ; Bias ; Breast ; Breast surgery ; Clinical trials ; Comparative analysis ; Confidence intervals ; Consumption ; Continuity (mathematics) ; Dosage and administration ; Epidural ; Management ; Medical personnel ; Medicine and Health Sciences ; Meta-analysis ; Methods ; Morphine ; Nausea ; Nerve block ; Ostomy ; Pain perception ; Patient outcomes ; Physical Sciences ; Research and Analysis Methods ; Safety ; Secondary data analysis ; Standard deviation ; Statistical analysis ; Subgroups ; Surgery ; Systematic review ; Thoracic surgery ; Thorax ; Ultrasonic imaging</subject><ispartof>PloS one, 2020-10, Vol.15 (10), p.e0237363-e0237363</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Huan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Huan et al 2020 Huan et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-45c6e478a9520cc4615dceb16cc8f81eab3820cf12ad023e5ecd3109fec913b23</citedby><cites>FETCH-LOGICAL-c669t-45c6e478a9520cc4615dceb16cc8f81eab3820cf12ad023e5ecd3109fec913b23</cites><orcidid>0000-0002-7837-8906</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7535861/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7535861/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids></links><search><contributor>Farag, Ehab</contributor><creatorcontrib>Huan, Sheng</creatorcontrib><creatorcontrib>Deng, Youming</creatorcontrib><creatorcontrib>Wang, Jia</creatorcontrib><creatorcontrib>Ji, Yihao</creatorcontrib><creatorcontrib>Yin, Guoping</creatorcontrib><creatorcontrib>Farag, Ehab</creatorcontrib><title>Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis</title><title>PloS one</title><description>Objective To evaluate the analgesic efficacy and safety of paravertebral block (PVB) versus intercostal nerve block (INB) in thoracic surgery and breast surgery. Methods The PubMed, Web of Science, Embase and the Cochrane Library were searched up to February 2020 for all available randomized controlled trials (RCTs) that evaluated the analgesic efficacy and safety of PVB compared with INB after thoracic surgery and breast surgery. For binary variables, odds ratio (OR) and 95% confidence interval (CI) was used. For continuous variables, weighted mean difference (WMD) and 95% confidence interval (CI) were used. RevMan5. 3 and Stata/MP 14.0 were used for performing the meta-analysis. Results A total of 9 trials including 440 patients (PVB block:222 patients; INB: 218 patients) met the inclusion criteria. In the primary outcome, there was no significant differences between the two groups with respect to postoperative visual analogue scale (VAS) at 1h (Std. MD = -0. 20; 95% CI = -1. 11to 0. 71; P = 0. 66), 2h (Std. MD = -0. 71; 95% CI = -2. 32to 0. 91; P = 0. 39), 24h (Std. MD = -0. 36; 95% CI = -0. 73 to -0. 00; P = 0. 05) and 48h (Std. MD = -0. 04; 95% CI = -0. 20 to 0. 11; P = 0. 57). However, there was significant difference in VAS of non Chinese subgroup at 1h (Std. MD = 0. 33; 95% CI = 0. 25to 0. 41; P<0. 00001) and VAS of Chinese subgroup at 24h (Std. MD = -0.32; 95% CI = -0.49 to-0.14; P = 0.0003). In the secondary outcome, the analysis also showed no significant difference between the groups according to the rates of postoperative nausea and vomit (OR = 0. 63; 95% CI = 0. 38 to 1. 03; P = 0. 06) and the rates of postoperative additional analgesia (OR = 0. 57; 95% CI = 0. 21 to 1. 55; P = 0. 27). There was significant difference in postoperative consumption of morphine (Std. MD = -14. 57; 95% CI = -26. 63 to -0.25; P = 0. 02). Conclusion Compared with INB, PVB can provide better analgesia efficacy and cause lower consumption of morphine after thoracic surgery and breast surgery.</description><subject>Analgesia</subject><subject>Anesthesiology</subject><subject>Bias</subject><subject>Breast</subject><subject>Breast surgery</subject><subject>Clinical trials</subject><subject>Comparative analysis</subject><subject>Confidence intervals</subject><subject>Consumption</subject><subject>Continuity (mathematics)</subject><subject>Dosage and administration</subject><subject>Epidural</subject><subject>Management</subject><subject>Medical personnel</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Methods</subject><subject>Morphine</subject><subject>Nausea</subject><subject>Nerve block</subject><subject>Ostomy</subject><subject>Pain perception</subject><subject>Patient outcomes</subject><subject>Physical Sciences</subject><subject>Research and Analysis Methods</subject><subject>Safety</subject><subject>Secondary data analysis</subject><subject>Standard deviation</subject><subject>Statistical analysis</subject><subject>Subgroups</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Thoracic surgery</subject><subject>Thorax</subject><subject>Ultrasonic 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and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis</title><author>Huan, Sheng ; Deng, Youming ; Wang, Jia ; Ji, Yihao ; Yin, Guoping ; Farag, Ehab</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-45c6e478a9520cc4615dceb16cc8f81eab3820cf12ad023e5ecd3109fec913b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Analgesia</topic><topic>Anesthesiology</topic><topic>Bias</topic><topic>Breast</topic><topic>Breast surgery</topic><topic>Clinical trials</topic><topic>Comparative analysis</topic><topic>Confidence intervals</topic><topic>Consumption</topic><topic>Continuity (mathematics)</topic><topic>Dosage and administration</topic><topic>Epidural</topic><topic>Management</topic><topic>Medical personnel</topic><topic>Medicine and Health Sciences</topic><topic>Meta-analysis</topic><topic>Methods</topic><topic>Morphine</topic><topic>Nausea</topic><topic>Nerve block</topic><topic>Ostomy</topic><topic>Pain perception</topic><topic>Patient outcomes</topic><topic>Physical Sciences</topic><topic>Research and Analysis Methods</topic><topic>Safety</topic><topic>Secondary data analysis</topic><topic>Standard deviation</topic><topic>Statistical analysis</topic><topic>Subgroups</topic><topic>Surgery</topic><topic>Systematic review</topic><topic>Thoracic surgery</topic><topic>Thorax</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huan, Sheng</creatorcontrib><creatorcontrib>Deng, Youming</creatorcontrib><creatorcontrib>Wang, Jia</creatorcontrib><creatorcontrib>Ji, Yihao</creatorcontrib><creatorcontrib>Yin, Guoping</creatorcontrib><creatorcontrib>Farag, Ehab</creatorcontrib><collection>CrossRef</collection><collection>Gale In Context: Opposing 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one</jtitle><date>2020-10-05</date><risdate>2020</risdate><volume>15</volume><issue>10</issue><spage>e0237363</spage><epage>e0237363</epage><pages>e0237363-e0237363</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Objective To evaluate the analgesic efficacy and safety of paravertebral block (PVB) versus intercostal nerve block (INB) in thoracic surgery and breast surgery. Methods The PubMed, Web of Science, Embase and the Cochrane Library were searched up to February 2020 for all available randomized controlled trials (RCTs) that evaluated the analgesic efficacy and safety of PVB compared with INB after thoracic surgery and breast surgery. For binary variables, odds ratio (OR) and 95% confidence interval (CI) was used. For continuous variables, weighted mean difference (WMD) and 95% confidence interval (CI) were used. RevMan5. 3 and Stata/MP 14.0 were used for performing the meta-analysis. Results A total of 9 trials including 440 patients (PVB block:222 patients; INB: 218 patients) met the inclusion criteria. In the primary outcome, there was no significant differences between the two groups with respect to postoperative visual analogue scale (VAS) at 1h (Std. MD = -0. 20; 95% CI = -1. 11to 0. 71; P = 0. 66), 2h (Std. MD = -0. 71; 95% CI = -2. 32to 0. 91; P = 0. 39), 24h (Std. MD = -0. 36; 95% CI = -0. 73 to -0. 00; P = 0. 05) and 48h (Std. MD = -0. 04; 95% CI = -0. 20 to 0. 11; P = 0. 57). However, there was significant difference in VAS of non Chinese subgroup at 1h (Std. MD = 0. 33; 95% CI = 0. 25to 0. 41; P<0. 00001) and VAS of Chinese subgroup at 24h (Std. MD = -0.32; 95% CI = -0.49 to-0.14; P = 0.0003). In the secondary outcome, the analysis also showed no significant difference between the groups according to the rates of postoperative nausea and vomit (OR = 0. 63; 95% CI = 0. 38 to 1. 03; P = 0. 06) and the rates of postoperative additional analgesia (OR = 0. 57; 95% CI = 0. 21 to 1. 55; P = 0. 27). There was significant difference in postoperative consumption of morphine (Std. MD = -14. 57; 95% CI = -26. 63 to -0.25; P = 0. 02). Conclusion Compared with INB, PVB can provide better analgesia efficacy and cause lower consumption of morphine after thoracic surgery and breast surgery.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>33017425</pmid><doi>10.1371/journal.pone.0237363</doi><tpages>e0237363</tpages><orcidid>https://orcid.org/0000-0002-7837-8906</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analgesia Anesthesiology Bias Breast Breast surgery Clinical trials Comparative analysis Confidence intervals Consumption Continuity (mathematics) Dosage and administration Epidural Management Medical personnel Medicine and Health Sciences Meta-analysis Methods Morphine Nausea Nerve block Ostomy Pain perception Patient outcomes Physical Sciences Research and Analysis Methods Safety Secondary data analysis Standard deviation Statistical analysis Subgroups Surgery Systematic review Thoracic surgery Thorax Ultrasonic imaging |
| title | Efficacy and safety of paravertebral block versus intercostal nerve block in thoracic surgery and breast surgery: A systematic review and meta-analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-26T18%3A49%3A42IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Efficacy%20and%20safety%20of%20paravertebral%20block%20versus%20intercostal%20nerve%20block%20in%20thoracic%20surgery%20and%20breast%20surgery:%20A%20systematic%20review%20and%20meta-analysis&rft.jtitle=PloS%20one&rft.au=Huan,%20Sheng&rft.date=2020-10-05&rft.volume=15&rft.issue=10&rft.spage=e0237363&rft.epage=e0237363&rft.pages=e0237363-e0237363&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0237363&rft_dat=%3Cgale_plos_%3EA637508275%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2448621626&rft_id=info:pmid/33017425&rft_galeid=A637508275&rft_doaj_id=oai_doaj_org_article_090dc0d20ea64c249b3028d4d353362f&rfr_iscdi=true |