Superior hypogastric plexus (SHP) block during minimally invasive hysterectomy: a systematic reviewMohammed Abuzaid1, Ahmed Abu-Zaid2, Osama Alomar3, Ismail A. Al-Badawi3, Hani Salem31Department of Obstetrics and Gynecology, King Fahad Medical City, Riyadh, Saudi Arabia 2Department of Pharmacology, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, United States of America 3Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
OBJECTIVE: To systematically summarize the efficacy and safety of superior hypogastric plexus (SHP) block versus no SHP block among patients undergoing minimally invasive hysterectomy (MIH). METHODS: Five information sources were screened from inception until 04-April-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 nonrandomized comparative trials published in peer-reviewed journals. Owing to the very small number of available studies, methodologic heterogeneity, and procedural variances, it was not possible to carry out a quantitative meta-analysis. Hence, the results of the included studies were only reported qualitatively (descriptively). RESULTS: 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 low risk of bias. The results showed that SHP block appeared largely safe and could potentially 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. CONCLUSION: 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. Keywords: Superior hypogastric plexus, hysterectomy, minimally invasive surgery, postoperative pain, systematic review
Mohammed Abuzaid, Ahmed Abu-Zaid, Osama Alomar, Ismail A. Al-Badawi, Hani Salem. Superior hypogastric plexus (SHP) block during minimally invasive hysterectomy: a systematic review. . 2022; 19(2): 0-0
Corresponding Author: Ahmed Abu-Zaid, United States of America |
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