Association of peripheral nerve blocks with patient-reported quality of recovery in female patients receiving breast cancer surgery: a systematic review and meta-analysis of randomized controlled studies

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標題:	Association of peripheral nerve blocks with patient-reported quality of recovery in female patients receiving breast cancer surgery: a systematic review and meta-analysis of randomized controlled studies
作者:	Hung, Kuo-Chuan Ko, Ching-Chung Hsu, Chih-Wei Pang, Yu-Li Chen, Jen-Yin Sun, Cheuk-Kwan
貢獻者:	Chi Mei Hospital Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy & Science Chi Mei Hospital Department of Health and Nutrition, Chia Nan University of Pharmacy & Science National Sun Yat Sen University Chang Gung Memorial Hospital Chang Gung University E-Da Hospital I Shou University
關鍵字:	modified radical-mastectomy postoperative quality general-anesthesia pain score analgesia relief
日期:	2022
上傳時間:	2023-12-11 13:57:35 (UTC+8)
出版者:	SPRINGER
摘要:	Purpose This systematic review and meta-analysis investigated the impact of peripheral nerve blocks (PNBs) on patient-reported quality of recovery (QoR) following breast cancer surgery. Source Medline, EMBASE, Cochrane Library, and Google scholar databases were searched for randomized controlled trials (RCTs) comparing the QoR with or without PNBs in patients receiving breast cancer surgery from inception to September 2021. Using a random effects model, the primary outcome was total scores of postoperative QoR scales (i.e., QoR-15 and QoR-40). Principal findings Eight RCTs (QoR-15, n = 4; QoR-40, n = 4) involving 653 patients published from 2018 to 2021 were included. For the QoR-40 scale, pooled results revealed a significantly higher total score (mean difference [MD], 12.8 [8.2%]; 95% confidence interval [CI], 10.6 to 14.9; I-2 = 59%; five RCTs; n = 251) and scores on all subscales, except psychological support, in the PNB group than in controls at 24 hr after surgery. For the QoR-15 scale, pooled results also showed favorable QoR (MD, 7.7 [5.2%]; 95% CI, 4.9 to 10.5; I-2 = 75%; four RCTs; n = 402) in the PNB group at 24 hr after surgery. Sensitivity analysis showed no effect on the QoR-40 score and the difference in total QoR-15 score was no longer significant when a single trial was omitted. The use of PNBs was associated with a significantly lower opioid consumption and risk of postoperative nausea and vomiting without significant differences in the pain score between the two groups. Conclusion Our results verified the efficacy of PNBs for enhancing postoperative QoR using two validated patient-reported tools in female patients receiving breast cancer surgery under general anesthesia. Study registration PROSPERO (CRD42021272575); first submitted 9 August 2021.
關聯:	CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE, v.69, pp.1288–1299
Appears in Collections:	[醫務管理系(所)] 期刊論文 [保健營養系(所) ] 期刊論文

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