文献类型：期刊文献

英文题名：Transversus thoracic muscle plane block for pain during cardiac surgery: a systematic review and meta-analysis

作者：Xue, Jian-jun[1,2,3];Cui, Yi-yang[4];Busse, Jason W.[7,8];Ge, Long[5,6];Zhou, Ting[4];Huang, Wei-hua[4];Ding, Sheng-shuang[4];Zhang, Jie[4];Yang, Ke-hu[1,6]

第一作者：Xue, Jian-jun

通信作者：Yang, KH[1]

机构：[1]Lanzhou Univ, Evidence based Med Ctr, Sch Basic Med Sci, Lanzhou 730000, Gansu, Peoples R China;[2]Gansu Univ Chinese Med, Gansu Prov Hosp Tradit Chinese Med, Dept Anesthesiol, Chengguan Dist, Peoples R China;[3]Gansu Univ Chinese Med, Gansu Clin Res Ctr Integrat Anesthesiol, Chengguan Dist, Peoples R China;[4]Gansu Univ Chinese Med, Sch Clin Med 1, Chengguan Dist, Peoples R China;[5]Lanzhou Univ, Sch Publ Hlth, Key Lab Evidence Based Med & Knowledge Translat Ga, Lanzhou, Peoples R China;[6]Lanzhou Univ, Evidence Based Social Sci Res Ctr, Sch Publ Hlth, Lanzhou, Peoples R China;[7]McMaster Univ, Dept Anesthesia, Hamilton, ON, Canada;[8]McMaster Univ, Michael G DeGroote Natl Pain Ctr, Hamilton, ON, Canada

第一机构：Lanzhou Univ, Evidence based Med Ctr, Sch Basic Med Sci, Lanzhou 730000, Gansu, Peoples R China

通信机构：[1]corresponding author), Lanzhou Univ, Evidence based Med Ctr, Sch Basic Med Sci, Lanzhou 730000, Gansu, Peoples R China.

年份：2023

卷号：109

期号：8

起止页码：2500

外文期刊名：INTERNATIONAL JOURNAL OF SURGERY

收录：;Scopus(收录号：2-s2.0-85168428568);WOS:【SCI-EXPANDED(收录号:WOS:001051870800034)】；

基金：Gansu Province Science and Technology Foundation Program - Construction of the Center for Clinical Medical Research (20JR10RA435) Canadian Institutes of Health Research (CIHR).

语种：英文

外文关键词：cardiac surgery; local anesthesia; meta-analysis; opioids; postoperative pain; transversus thoracic muscle plane block

摘要：Study Objective:The role of transversus thoracic muscle plane blocks (TTMPBs) during cardiac surgery is controversial. We conducted a systematic review to establish the effectiveness of this procedure. Design:Systematic review. We searched PubMed, Embase, Web of Science, CENTRAL, WanFang Data, and the China National Knowledge Infrastructure to June 2022, and followed the GRADE approach to evaluate the certainty of evidence. Study Eligibility Criteria:Eligible studies enrolled adult patients scheduled to undergo cardiac surgery and randomized them to receive a TTMPB or no block/sham block. Main Results:Nine trials that enrolled 454 participants were included. Compared to no block/sham block, moderate certainty evidence found that TTMPB probably reduces postoperative pain at rest at 12 h [weighted mean difference (WMD) -1.51 cm on a 10 cm visual analogue scale for pain, 95% CI -2.02 to -1.00; risk difference (RD) for achieving mild pain or less (& LE;3 cm), 41%, 95% CI 17-65) and 24 h (WMD -1.07 cm, 95% CI -1.83 to -0.32; RD 26%, 95% CI 9-37). Moderate certainty evidence also supported that TTMPB probably reduces pain during movement at 12 h (WMD -3.42 cm, 95% CI -4.47 to -2.37; RD 46%, 95% CI 12-80) and at 24 h (WMD -1.73 cm, 95% CI -3.24 to -0.21; RD 32%, 95% CI 5-59), intraoperative opioid use [WMD -28 milligram morphine equivalent (MME), 95% CI -42 to -15], postoperative opioid consumption (WMD -17 MME, 95% CI -29 to -5), postoperative nausea and vomiting (absolute risk difference 255 less per 1000 persons, 95% CI 140-314), and intensive care unit (ICU) length of stay (WMD -13 h, 95% CI -21 to -6). Conclusion:Moderate certainty evidence showed TTMPB during cardiac surgery probably reduces postoperative pain at rest and with movement, opioid consumption, ICU length of stay, and the incidence of nausea and vomiting.