Key result
Superior hypogastric plexus (SHP) block during minimally invasive hysterectomy appeared safe and reduced postoperative pain and opioid consumption, though quantitative meta-analysis was not possible.
Why the study?
To systematically summarize the efficacy and safety of superior hypogastric plexus block versus no block in patients undergoing minimally invasive hysterectomy.
Does superior hypogastric plexus (SHP) block reduce postoperative pain and opioid consumption in patients undergoing minimally invasive hysterectomy?
Systematic Review (n=210)
Does superior hypogastric plexus (SHP) block reduce postoperative pain and opioid consumption in patients undergoing minimally invasive hysterectomy?
Superior hypogastric plexus block during minimally invasive hysterectomy is safe and provides potential analgesic and opioid-sparing effects postoperatively.
SHP block may warrant consideration to reduce pain and opioids after minimally invasive hysterectomy; leaves open need for RCTs to permit quantitative meta-analysis.
To systematically summarize the efficacy and safety of superior hypogastric plexus (SHP) block versus no SHP block among patients undergoing minimally invasive hysterectomy (MIH). Five information sources were screened from inception until 04.04.2022 and comprised the Cochrane Central Register of Controlled Trials, PubMed, Embase, Scopus, and Web of Science. The inclusion criteria comprised (i) patients: individuals undergoing MIH, (ii) intervention: SHP block, (iii) Comparator: no SHP block, (iv) Outcomes: postoperative pain, postoperative opioid consumption, operation time, estimated intraoperative blood loss, hospital stay, and complications/toxicities, and (v) Study design: randomized controlled trials (RCTs) and non-randomized comparative trials published in peer-reviewed journals. Owing to the insignificant number of available studies, methodologic heterogeneity, and procedural variances, it was impossible to carry out a quantitative meta-analysis. Hence, the results of the included studies were only reported qualitatively (descriptively). Three studies (2 RCTs and 1 cohort study), comprising 210 patients (SHP=107 and non-SHP=103) were included in the qualitative synthesis. Overall, the included studies had a low risk of bias. The results showed that SHP block appeared largely safe and could reduce postoperative pain and opioid consumption. However, SHP block did not offer clinical benefits in terms of reduced operation time, intraoperative blood loss, and hospital stay compared with non-SHP block. Among patients undergoing MIH, this first ever systematic review showed that SHP block was safe and exhibited potential analgesic and opioid-sparing effects postoperatively. Additional RCTs are needed to carry out a powered meta-analysis and validate the findings.
No takes yet. Share an insight, caveat, or question.
Alomar et al. (2022) conducted a systematic review in Minimally invasive hysterectomy (n=210). Superior hypogastric plexus (SHP) block vs. No SHP block was evaluated on Postoperative pain, postoperative opioid consumption, operation time, estimated intraoperative blood loss, hospital stay, and complications/toxicities. Superior hypogastric plexus (SHP) block during minimally invasive hysterectomy appeared safe and reduced postoperative pain and opioid consumption, though quantitative meta-analysis was not possible.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: