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

Analgesics, Opioid Humans Liver Nerve Block Pain Management Pain, Postoperative / diagnosis
analgesia pain pain management postoperative

Journal

Regional anesthesia and pain medicine
ISSN: 1532-8651
Titre abrégé: Reg Anesth Pain Med
Pays: England
ID NLM: 9804508

Informations de publication

Date de publication:
05 2021
Historique:
received: 21 07 2020
revised: 20 11 2020
accepted: 22 12 2020
pubmed: 14 1 2021
medline: 13 7 2021
entrez: 13 1 2021
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du 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.

Identifiants

DOI: 10.1136/rapm-2020-101933 PMID: 33436442 PMC: PMC8070600
pubmed: 33436442
pii: rapm-2020-101933
doi: 10.1136/rapm-2020-101933
pmc: PMC8070600
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

433-445

Informations de copyright

© American Society of Regional Anesthesia & Pain Medicine 2021. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: GJ has received honoraria from Baxter and Pacira Pharmaceuticals. FB has received honoraria from Pfizer, The Medicine Company, Abbott France, Nordic Pharma France, Heron therapeutics, AMBU and Grunenthal. MVdV has received honoraria from Sintetica, Grunenthal, Vifor Pharma, MSD, Nordic Pharma, Janssen Pharmaceuticals, Heron Therapeutics and Aguettant. EP-Z has received honoraria form Mundipharma, Grunenthal, MSD, Janssen-Cilag GmbH, Fresenius Kabi and AcelRx.

Références

HPB (Oxford). 2019 Aug;21(8):945-952
pubmed: 30879991
Br J Anaesth. 2009 Feb;102(2):179-90
pubmed: 19139027
J Surg Oncol. 2019 Apr;119(5):660-666
pubmed: 30802314
World J Hepatol. 2016 Sep 18;8(26):1097-104
pubmed: 27660677
Transplant Proc. 2017 Jul - Aug;49(6):1351-1356
pubmed: 28736006
J Clin Anesth. 2017 Feb;37:103-107
pubmed: 28235493
Saudi J Anaesth. 2016 Apr-Jun;10(2):132-7
pubmed: 27051361
Med Sci Monit. 2019 Feb 07;25:1053-1060
pubmed: 30730866
J Clin Lab Anal. 2018 Jul;32(6):e22434
pubmed: 29574998
Reg Anesth Pain Med. 2010 Jan-Feb;35(1):51-6
pubmed: 20048658
Rev Assoc Med Bras (1992). 2018 Feb;64(2):175-180
pubmed: 29641671
Anesth Analg. 2007 Jun;104(6):1409-14, table of contents
pubmed: 17513633
Ann Surg. 2019 Aug;270(2):200-208
pubmed: 31058695
Best Pract Res Clin Anaesthesiol. 2019 Sep;33(3):259-267
pubmed: 31785712
Liver Transpl. 2013 Sep;19(9):1036-45
pubmed: 23788468
Anesthesiology. 2004 Oct;101(4):950-9
pubmed: 15448529
Liver Transpl. 2009 Apr;15(4):381-9
pubmed: 19326422
Anesth Analg. 2002 Nov;95(5):1179-81, table of contents
pubmed: 12401587
Hepatobiliary Surg Nutr. 2016 Apr;5(2):159-75
pubmed: 27115011
Korean J Anesthesiol. 2019 Apr;72(2):119-129
pubmed: 30841029
Proc (Bayl Univ Med Cent). 2014 Oct;27(4):305-12
pubmed: 25484494
BMC Anesthesiol. 2019 Feb 18;19(1):23
pubmed: 30777027
Eur J Surg Oncol. 2016 Oct;42(10):1561-7
pubmed: 27528466
HPB (Oxford). 2012 Sep;14(9):611-8
pubmed: 22882198
Best Pract Res Clin Anaesthesiol. 2019 Sep;33(3):303-315
pubmed: 31785716
J Surg Oncol. 2019 Jan;119(1):47-55
pubmed: 30481374
Colorectal Dis. 2013 Feb;15(2):146-55
pubmed: 23350836
Anaesthesia. 2010 Jul;65(7):721-8
pubmed: 20528839
Anaesthesia. 2010 Dec;65(12):1180-6
pubmed: 20958277
Ann Surg. 2019 Aug;270(2):193-199
pubmed: 30676382
World J Gastroenterol. 2017 Sep 28;23(36):6733-6740
pubmed: 29085218
J Eval Clin Pract. 2020 Jun;26(3):992-1000
pubmed: 31407484
BMC Anesthesiol. 2020 Mar 2;20(1):53
pubmed: 32122319
Ann Surg. 2018 Aug;268(2):233-240
pubmed: 29300708
Reg Anesth Pain Med. 2016 Jul-Aug;41(4):460-8
pubmed: 27281726
BMC Anesthesiol. 2018 Apr 10;18(1):36
pubmed: 29631564
Am J Surg. 2018 Jan;215(1):138-143
pubmed: 28958651
Br J Surg. 2015 Jun;102(7):805-12
pubmed: 25877255
J Clin Anesth. 2018 Dec;51:20-31
pubmed: 30064083
Anaesthesia. 2019 Oct;74(10):1298-1304
pubmed: 31292953
Local Reg Anesth. 2014 May 29;7:27-37
pubmed: 24971036
Front Pharmacol. 2018 Jan 04;8:940
pubmed: 29354054
J Anaesthesiol Clin Pharmacol. 2019 Jan-Mar;35(1):58-64
pubmed: 31057242
Middle East J Anaesthesiol. 2014 Jun;22(5):467-76
pubmed: 25137863
Clin J Pain. 2014 Jul;30(7):571-6
pubmed: 24281275
Anesthesiology. 2005 Oct;103(4):813-20
pubmed: 16192774
Br J Surg. 2015 Dec;102(13):1619-28
pubmed: 26447461
Pharmacology. 2006;77(4):161-5
pubmed: 16837779
Front Med (Lausanne). 2018 Feb 26;5:44
pubmed: 29536008
Br J Anaesth. 2017 Mar 1;118(3):424-429
pubmed: 28186223
Dig Liver Dis. 2015 Dec;47(12):1039-46
pubmed: 26362614
Anaesthesia. 2013 Jun;68(6):628-35
pubmed: 23662750
Br J Clin Pharmacol. 2015 Jul;80(1):67-74
pubmed: 25557141
Arch Surg. 2010 Mar;145(3):281-4
pubmed: 20231630
BMC Res Notes. 2018 Nov 26;11(1):834
pubmed: 30477577
Ann Surg. 2019 Mar;269(3):413-419
pubmed: 30080727
Reg Anesth Pain Med. 2014 Nov-Dec;39(6):506-12
pubmed: 25304475

Auteurs

Audrey Dieu (A)

Department of Anesthesiology, Cliniques universitaires Saint-Luc, Bruxelles, Belgium audrey.dieu@uclouvain.be.
ORCID: 0000-0002-6026-1734

Philippe Huynen (P)

Department of Cardiovascular Sciences, KULeuven, Leuven, Belgium.

Patricia Lavand'homme (P)

Department of Anesthesiology, Cliniques universitaires Saint-Luc, Bruxelles, Belgium.

Hélène Beloeil (H)

Anesthesia and Intensive Care Department, University of Rennes, CHU Rennes, Inserm, INRA, CIC 1414 NuMeCan, Rennes, France.

Stephan M Freys (SM)

Department of Surgery, DIAKO Ev. Diakonie-Krankenhaus, Bremen, Germany.

Esther M Pogatzki-Zahn (EM)

Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Münster, Münster, Germany.

Girish P Joshi (GP)

Department of Anesthesiology and Pain Management, University of Texas, Southwestern Medical Center, Dallas, Texas, USA.

Marc Van de Velde (M)

Department of Cardiovascular Sciences, KULeuven, Leuven, Belgium.
Department of Anesthesiology, UZ Leuven, Leuven, Belgium.

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questionsmedicales.fr › Système digestif › Foie › Pain management after open liver resection:...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de neurochirurgie › Dénervation › Bloc nerveux › Pain management after open liver resection:...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Prise en charge de la maladie › Gestion de la douleur › Pain management after open liver resection:...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Douleur postopératoire › Pain management after open liver resection:...