Effect of thoracic paravertebral nerve block on delirium in patients after video-assisted thoracoscopic surgery: a systematic review and meta-analysis of randomized controlled trials
BackgroundNerve blocks are widely used in various surgeries to alleviate postoperative pain and promote recovery. However, the impact of nerve block on delirium remains contentious. This study aims to systematically evaluate the influence of Thoracic Paravertebral Nerve Block (TPVB) on the incidence...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-04-01
|
| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1347991/full |
| _version_ | 1797215907979722752 |
|---|---|
| author | Xuelei Zhou Wei Mao Li Zhao Hongyu Zhu Linlin Chen Ying Xie Linji Li |
| author_facet | Xuelei Zhou Wei Mao Li Zhao Hongyu Zhu Linlin Chen Ying Xie Linji Li |
| author_sort | Xuelei Zhou |
| collection | DOAJ |
| description | BackgroundNerve blocks are widely used in various surgeries to alleviate postoperative pain and promote recovery. However, the impact of nerve block on delirium remains contentious. This study aims to systematically evaluate the influence of Thoracic Paravertebral Nerve Block (TPVB) on the incidence of delirium in patients post Video-Assisted Thoracoscopic Surgery (VATS).MethodsWe conducted a systematic search of PubMed, Embase, Web of Science, Cochrane Library, and Scopus databases in June 2023. The search strategy combined free-text and Medical Subject Headings (MeSH) terms, including perioperative cognitive dysfunction, delirium, postoperative cognitive dysfunction, paravertebral nerve block, thoracic surgery, lung surgery, pulmonary surgery, and esophageal/esophagus surgery. We utilized a random effects model for the analysis and synthesis of effect sizes.ResultsWe included a total of 9 RCTs involving 1,123 participants in our study. In VATS, TPVB significantly reduced the incidence of delirium on postoperative day three (log(OR): −0.62, 95% CI [−1.05, −0.18], p = 0.01, I2 = 0.00%) and postoperative day seven (log(OR): −0.94, 95% CI [−1.39, −0.49], p < 0.001, I2 = 0.00%). Additionally, our study indicates the effectiveness of TPVB in postoperative pain relief (g: −0.82, 95% CI [−1.15, −0.49], p < 0.001, I2 = 72.60%).ConclusionThe comprehensive results suggest that in patients undergoing VATS, TPVB significantly reduces the incidence of delirium and notably diminishes pain scores.Systematic review registrationCRD42023435528. https://www.crd.york.ac.uk/PROSPERO. |
| first_indexed | 2024-04-24T11:37:32Z |
| format | Article |
| id | doaj.art-aac2d461dab44628af9afc001a756207 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-24T11:37:32Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-aac2d461dab44628af9afc001a7562072024-04-10T04:33:37ZengFrontiers Media S.A.Frontiers in Neurology1664-22952024-04-011510.3389/fneur.2024.13479911347991Effect of thoracic paravertebral nerve block on delirium in patients after video-assisted thoracoscopic surgery: a systematic review and meta-analysis of randomized controlled trialsXuelei ZhouWei MaoLi ZhaoHongyu ZhuLinlin ChenYing XieLinji LiBackgroundNerve blocks are widely used in various surgeries to alleviate postoperative pain and promote recovery. However, the impact of nerve block on delirium remains contentious. This study aims to systematically evaluate the influence of Thoracic Paravertebral Nerve Block (TPVB) on the incidence of delirium in patients post Video-Assisted Thoracoscopic Surgery (VATS).MethodsWe conducted a systematic search of PubMed, Embase, Web of Science, Cochrane Library, and Scopus databases in June 2023. The search strategy combined free-text and Medical Subject Headings (MeSH) terms, including perioperative cognitive dysfunction, delirium, postoperative cognitive dysfunction, paravertebral nerve block, thoracic surgery, lung surgery, pulmonary surgery, and esophageal/esophagus surgery. We utilized a random effects model for the analysis and synthesis of effect sizes.ResultsWe included a total of 9 RCTs involving 1,123 participants in our study. In VATS, TPVB significantly reduced the incidence of delirium on postoperative day three (log(OR): −0.62, 95% CI [−1.05, −0.18], p = 0.01, I2 = 0.00%) and postoperative day seven (log(OR): −0.94, 95% CI [−1.39, −0.49], p < 0.001, I2 = 0.00%). Additionally, our study indicates the effectiveness of TPVB in postoperative pain relief (g: −0.82, 95% CI [−1.15, −0.49], p < 0.001, I2 = 72.60%).ConclusionThe comprehensive results suggest that in patients undergoing VATS, TPVB significantly reduces the incidence of delirium and notably diminishes pain scores.Systematic review registrationCRD42023435528. https://www.crd.york.ac.uk/PROSPERO.https://www.frontiersin.org/articles/10.3389/fneur.2024.1347991/fulldeliriumthoracic paravertebral nerve blockthoracic surgery thoracoscopythoracoscopepostoperative analgesiameta-analysis |
| spellingShingle | Xuelei Zhou Wei Mao Li Zhao Hongyu Zhu Linlin Chen Ying Xie Linji Li Effect of thoracic paravertebral nerve block on delirium in patients after video-assisted thoracoscopic surgery: a systematic review and meta-analysis of randomized controlled trials Frontiers in Neurology delirium thoracic paravertebral nerve block thoracic surgery thoracoscopy thoracoscope postoperative analgesia meta-analysis |
| title | Effect of thoracic paravertebral nerve block on delirium in patients after video-assisted thoracoscopic surgery: a systematic review and meta-analysis of randomized controlled trials |
| title_full | Effect of thoracic paravertebral nerve block on delirium in patients after video-assisted thoracoscopic surgery: a systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Effect of thoracic paravertebral nerve block on delirium in patients after video-assisted thoracoscopic surgery: a systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Effect of thoracic paravertebral nerve block on delirium in patients after video-assisted thoracoscopic surgery: a systematic review and meta-analysis of randomized controlled trials |
| title_short | Effect of thoracic paravertebral nerve block on delirium in patients after video-assisted thoracoscopic surgery: a systematic review and meta-analysis of randomized controlled trials |
| title_sort | effect of thoracic paravertebral nerve block on delirium in patients after video assisted thoracoscopic surgery a systematic review and meta analysis of randomized controlled trials |
| topic | delirium thoracic paravertebral nerve block thoracic surgery thoracoscopy thoracoscope postoperative analgesia meta-analysis |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1347991/full |
| work_keys_str_mv | AT xueleizhou effectofthoracicparavertebralnerveblockondeliriuminpatientsaftervideoassistedthoracoscopicsurgeryasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT weimao effectofthoracicparavertebralnerveblockondeliriuminpatientsaftervideoassistedthoracoscopicsurgeryasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT lizhao effectofthoracicparavertebralnerveblockondeliriuminpatientsaftervideoassistedthoracoscopicsurgeryasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT hongyuzhu effectofthoracicparavertebralnerveblockondeliriuminpatientsaftervideoassistedthoracoscopicsurgeryasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT linlinchen effectofthoracicparavertebralnerveblockondeliriuminpatientsaftervideoassistedthoracoscopicsurgeryasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT yingxie effectofthoracicparavertebralnerveblockondeliriuminpatientsaftervideoassistedthoracoscopicsurgeryasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT linjili effectofthoracicparavertebralnerveblockondeliriuminpatientsaftervideoassistedthoracoscopicsurgeryasystematicreviewandmetaanalysisofrandomizedcontrolledtrials |