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Updated: Jul 18, 2025

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
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Rectus Sheath Block in Abdominal Surgery: A Systematic Review with Meta-Analysis.

Yerkin Abdildin1, Karina Tapinova2, Azamat Salamat1

  • 1School of Engineering and Digital Sciences, Nazarbayev University, Astana, Kazakhstan.

Romanian Journal of Anaesthesia and Intensive Care
|August 28, 2023
PubMed
Summary
This summary is machine-generated.

Rectus sheath block (RSB) shows no significant benefit for abdominal surgery patients. This regional analgesia technique did not reduce pain, opioid use, or anesthetic consumption compared to standard care.

Keywords:
abdominal surgeryopioid consumptionpostoperative pain intensityrectus sheath blocktime to first opioid

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Area of Science:

  • Anesthesiology
  • Surgical Pain Management

Background:

  • Regional analgesia techniques like rectus sheath block (RSB) are developing with ultrasound and laparoscopic guidance.
  • Despite advancements, studies on RSB's efficacy in abdominal surgery yield controversial results.

Purpose of the Study:

  • To systematically review and meta-analyze randomized controlled trials (RCTs) evaluating the effect of RSB in adult patients undergoing abdominal surgery.
  • To assess the impact of RSB on postoperative pain intensity and opioid consumption.

Main Methods:

  • A systematic literature search was conducted on PubMed, Google Scholar, and Cochrane Library up to October 2021.
  • Eight RCTs involving 386 patients were included. Primary outcomes were postoperative pain and opioid consumption.
  • Data analysis used Review Manager software (RevMan v. 5.4), with heterogeneity assessed by I² statistic and study quality by the Jadad Scale.

Main Results:

  • Patients receiving RSB did not show reduced anesthetic or opioid consumption compared to the control group.
  • Postoperative pain intensity (on a 0-10 scale) was not significantly lower in the RSB group.
  • Time to the first opioid/analgesic administration was not improved with RSB compared to non-RSB methods.

Conclusions:

  • Current evidence does not support the routine use of RSB over non-RSB techniques for reducing anesthetic and opioid consumption in abdominal surgery.
  • RSB did not demonstrate a statistically significant advantage in decreasing postoperative pain or delaying the need for analgesics.