Rectus Sheath Block in Abdominal Surgery: A Systematic Review with Meta-Analysis

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.