Comparative efficacy and safety of non-neuraxial analgesic techniques for midline laparotomy: a systematic review and frequentist network meta-analysis of randomised controlled trials
Authors' conclusion
Based on current evidence, continuous rectus sheath block and continuous transversus abdominis plane block were the most efficacious non-neuraxial techniques at reducing 24-h cumulative opioid consumption and 24-h resting pain scores after midline laparotomy (low certainty).
Study context
- Population
- Adults undergoing midline laparotomy
- Participants
- 4,410 adults · 67 studies
- Comparison
- Non-neuraxial analgesic techniques vs placebo/no intervention
- Outcome
- Co-primary: cumulative opioid consumption (i.v. morphine equivalents) and resting pain score (11-point NRS)
- Follow-up
- 24 h
Methodological detailsrandom-effects model, cluster-rank analysis
- Random-effects model
- Cluster-rank analysis
Pooled result
As reported in the abstract
Each group vs Placebo/no interventionMD, mg (95% CI)
sQLBopioid consumption; very low certainty
−16.1(−29.9 to −2.3)
cTAPopioid consumption; low certainty
−14.0(−21.6 to −6.4)
sTAPopioid consumption; low certainty
−13.7(−17.4 to −10.0)
cRSBopioid consumption; low certainty
−13.2(−20.3 to −6.1)
Each group vs Placebo/no interventionMD (95% CI)
cRSBresting pain score; low certainty
−1.2(−1.8 to −0.6)
cTAPresting pain score; low certainty
−1.0(−1.7 to −0.2)
cWIresting pain score; low certainty
−0.7(−1.1 to −0.4)
Original publication
Comparative efficacy and safety of non-neuraxial analgesic techniques for midline laparotomy: a systematic review and frequentist network meta-analysis of randomised controlled trials. Br J Anaesth. Published 26 September 2023. doi:10.
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