Comparison of rectus sheath block and local anesthetic for analgesia in pediatric umbilical hernia repair: A systematic review and meta-analysis

Abstract

Background: Pediatric umbilical hernia repair could cause considerable postoperative discomfort. This study aimed to compare the analgesia between rectus sheath block and local anesthetic infiltration in child pediatric umbilical hernia repair. Methods: The relevant randomized controlled trials were searched from PubMed, Embase, Web of Science, EBSCO, and Cochrane library databases from its inception to October 2020. The random-effects model was used for meta-analysis. Results: Four randomized controlled trials were included in the meta-analysis. The 4 studies were published between 2006 and 2017, with sample sizes ranging from 13 to 52 and a total of 143 individuals across the 4 studies. The Jadad scores of the 4 included studies ranged from 4 to 5, and all 4 studies were considered high quality based on quality assessment. There was no difference in analgesic effect at 10 minutes (standardized mean difference [SMD] =-0.19; 95% confidence interval [CI] =-1.52 to 1.16; P =.78), 30 minutes (SMD =-0.37; 95% CI =-1.53 to 0.78; P =.52), 1 hour (SMD =-0.73; 95% CI =-2.00 to 0.53; P =.26) after surgery. Besides, there was no significant difference in postoperative nausea (risk ratio = 0.95; 95% CI = 0.18 to 5.02; P =.95) and postoperative morphine use in morphine equivalents (mean difference =-0.95; 95% CI =-0.06 to 0.01; P =.12). Conclusion: Rectus sheath block and local anesthetic are effective methods for analgesia in pediatric umbilical hernia repair.