Analgesic safety and efficacy of regional anesthetic blocks in anterior lumbar interbody fusion surgery: A systematic review with meta-analyses
Abstract
Background: Anterior regional anesthetic blocks have been utilized as a part of a multi-modal pain regimen in patients undergoing abdominal surgery. Recently, studies have investigated their safety and efficacy in anterior lumbar interbody fusion (ALIF) surgery.
Methods: A systematic literature search was conducted through MEDLINE, Embase, and Cochrane Library on January 30, 2024, for articles investigating the safety and efficacy of preoperative regional blocks in patients undergoing ALIF surgery compared to patients who did not receive a preoperative regional block. Meta-analyses were performed to calculate the pooled mean difference with 95% confidence intervals (CI) using a random-effects model. Criteria for inclusion were patients undergoing ALIF surgery; sample size of ≥ 5 patients in each study group; patient population that pre-operatively received an anterior abdominal regional block; patient population age ≥ 18 years; available data regarding postoperative numerical pain scores and opioid requirements. Studies with overlapping patient data already included for the analysis and lack of pre-specified data were excluded.
Results: Four studies were included in the pooled analysis with a total number of 415 patients. The results of the pooled analysis showed that in patients undergoing ALIF surgery, a preoperative regional block resulted in a decrease in opioid requirements at 48 hours post-operatively (MD -0.37, 95% CI [-0.63 to -0.11], I2 = 6.38%, P = .005) and 72…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 415 participants or records.
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