Most effective pain-control procedure for open liver surgery: a network meta-analysis

Area of Science:

• Anesthesiology and Pain Management
• Surgical Oncology
• Evidence-Based Medicine

Background:

• Open liver surgery poses significant post-operative pain challenges.
• Effective pain management is crucial for patient recovery and outcomes.
• Identifying optimal pain control strategies is an ongoing clinical need.

Purpose of the Study:

• To identify the most effective pain control procedure for open liver surgery.
• To provide evidence-based direction for future pain management development.
• To conduct a network meta-analysis of randomized controlled trials.

Main Methods:

• Systematic literature search of PubMed, Embase, and Cochrane Library up to July 2016.
• Network meta-analysis of post-operative pain scores (4-8h, 24h) at rest and on movement.
• Ranking of pain control strategies using cumulative probability and testing for inconsistency.

Main Results:

• Twelve randomized controlled trials involving 661 patients were analyzed.
• Intrathecal analgesia plus intravenous analgesia demonstrated superior pain control at 4-8h and 24h post-surgery.
• No significant inconsistency was found between study results.

Conclusions:

• Combined intrathecal and intravenous analgesia offers the most effective pain control for open liver surgery.
• Development of comprehensive, systematic pain control protocols is recommended.
• This finding guides clinical practice and future research in surgical pain management.