SYSTEMATIC REVIEW article
Front. Med.
Sec. Hepatobiliary Diseases
A comparison of regional anesthesia techniques for pain management in patients undergoing liver surgery: A Network Meta-analysis
Provisionally accepted
- Chengdu Second People's Hospital, Chengdu, China
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Objective: This research sought to evaluate the pain-relieving effectiveness and practicality of various regional anesthesia approaches in individuals undergoing hepatic procedures. Method: Ten randomized controlled trials involving 710 patients were included. We included any article that head-to-head evaluated at least two of the seven focal regional modalities: continuous subcutaneous/local anesthetic wound infusion (CLAI), continues erector spinae plane block (CESPB), thoracic epidural analgesia (EA), single-shot erector spinae plane block (ESPB), intrathecal morphine (ITM), quadratus lumborum block (QLB), or continuous thoracic paravertebral block (CTPVB). The primary outcome is the postoperative pain scores at rest and movement. The secondary outcomes encompassed 24-, 48-and 72-hours morphine use, inpatient stay, postoperative nausea/vomiting (PONV) incidence, and any untoward events. Results: For resting pain scores, pair-wise meta-analysis of EA compared with CLAI had no significant difference at 24 h (SMD = -0.71, 95% CI -2.09, -0.67) and at 48 h postoperatively (SMD = -0.13, 95% CI -0.74, -0.48). However, during movement, EA compared with CLAI had significant difference at 24 h (SMD = -1.71, 95% CI -2.26, -1.17) and 48 h (SMD = -0.99, 95% CI -1.46, -0.53) postoperatively. The current study did not provide a conclusion for morphine equivalent at 72 h, the incidence of
Keywords: liver surgery, regional anesthesia, Epidural analgesia, Network meta-analysis, Resting pain scores, morphine equivalent
Received: 23 Aug 2025; Accepted: 11 Nov 2025.
Copyright: © 2025 Sun, He, Zhou, Song, Zhang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ke Sun, sunke711@vip.qq.com
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