Pain management after open liver resection: Procedure-Specific Postoperative Pain Management (PROSPECT) recommendations - Université de Rennes Accéder directement au contenu
Article Dans Une Revue (Article De Synthèse) Regional Anesthesia and Pain Medicine Année : 2021

Pain management after open liver resection: Procedure-Specific Postoperative Pain Management (PROSPECT) recommendations

Résumé

BACKGROUND AND OBJECTIVES: Effective pain control improves postoperative rehabilitation and enhances recovery. The aim of this review was to evaluate the available evidence and to develop recommendations for optimal pain management after open liver resection using Procedure-Specific Postoperative Pain Management (PROSPECT) methodology. STRATEGY AND SELECTION CRITERIA: Randomized controlled trials (RCTs) published in the English language from January 2010 to October 2019 assessing pain after liver resection using analgesic, anesthetic or surgical interventions were identified from MEDLINE, Embase and Cochrane databases. RESULTS: Of 121 eligible studies identified, 31 RCTs and 3 systematic reviews met the inclusion criteria. Preoperative and intraoperative interventions that improved postoperative pain relief were non-steroidal anti-inflammatory drugs, continuous thoracic epidural analgesia, and subcostal transversus abdominis plane (TAP) blocks. Limited procedure-specific evidence was found for intravenous dexmedetomidine, intravenous magnesium, intrathecal morphine, quadratus lumborum blocks, paravertebral nerve blocks, continuous local anesthetic wound infiltration and postoperative interpleural local anesthesia. No evidence was found for intravenous lidocaine, ketamine, dexamethasone and gabapentinoids. CONCLUSIONS: Based on the results of this review, we suggest an analgesic strategy for open liver resection, including acetaminophen and non-steroidal anti-inflammatory drugs, combined with thoracic epidural analgesia or bilateral oblique subcostal TAP blocks. Systemic opioids should be considered as rescue analgesics. Further high-quality RCTs are needed to confirm and clarify the efficacy of the recommended analgesic regimen in the context of an enhanced recovery program.
Fichier principal
Vignette du fichier
RegAnesthPainMed_2021_Dieu_Pain%20management%20after%20open%20liver%20resection.pdf (472.47 Ko) Télécharger le fichier
Origine : Fichiers éditeurs autorisés sur une archive ouverte

Dates et versions

hal-03128449 , version 1 (25-05-2021)

Licence

Paternité - Pas d'utilisation commerciale

Identifiants

Citer

Audrey Dieu, Philippe Huynen, Patricia Lavand’homme, Hélène Beloeil, Stephan M Freys, et al.. Pain management after open liver resection: Procedure-Specific Postoperative Pain Management (PROSPECT) recommendations. Regional Anesthesia and Pain Medicine, 2021, 46 (5), pp.433-445. ⟨10.1136/rapm-2020-101933⟩. ⟨hal-03128449⟩
218 Consultations
69 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More