Evidence map›Paper›PMID 32383052›Full record

SynthesisWorld journal of surgery2020

Local Anaesthesia Alone Versus Regional or General Anaesthesia in Excisional Haemorrhoidectomy: A Systematic Review and Meta-Analysis.

Weisi Xia, Hoani S MacFater, Wiremu S MacFater, Bacil F Otutaha, Ahmed W H Barazanchi, Tarik Sammour, Andrew G Hill

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in World journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Weisi XiaDepartment of Surgery, South Auckland Clinical Campus, Middlemore Hospital, The University of Auckland, Private Bag 93311, Otahuhu, Auckland, New Zealand. w.xia@auckland.ac.nz.ORCID http://orcid.org/0000-0003-0250-4942
Hoani S MacFaterDepartment of Surgery, South Auckland Clinical Campus, Middlemore Hospital, The University of Auckland, Private Bag 93311, Otahuhu, Auckland, New Zealand.
Wiremu S MacFaterDepartment of Surgery, South Auckland Clinical Campus, Middlemore Hospital, The University of Auckland, Private Bag 93311, Otahuhu, Auckland, New Zealand.
Bacil F OtutahaDepartment of Surgery, South Auckland Clinical Campus, Middlemore Hospital, The University of Auckland, Private Bag 93311, Otahuhu, Auckland, New Zealand.
Ahmed W H BarazanchiDepartment of Surgery, South Auckland Clinical Campus, Middlemore Hospital, The University of Auckland, Private Bag 93311, Otahuhu, Auckland, New Zealand.
Tarik SammourColorectal Unit, Department of Surgery, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia.
Andrew G HillDepartment of Surgery, South Auckland Clinical Campus, Middlemore Hospital, The University of Auckland, Private Bag 93311, Otahuhu, Auckland, New Zealand.
University of Auckland · NZRoyal Adelaide Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExcisional haemorrhoidectomy has been traditionally performed under general or regional anaesthesia. However, these modes are associated with complications such as nausea, urinary retention and motor blockade. Local anaesthesia (LA) alone has been proposed to reduce side effects as well as to expedite ambulatory surgery. This systematic review aims to assess LA versus regional or general anaesthesia for excisional haemorrhoidectomy.

methodsA systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, EMBASE and CENTRAL databases were searched to 13 January 2020. All randomised controlled trials comparing LA only versus regional or general anaesthesia in patients who received excisional haemorrhoidectomy were included. The main outcomes included pain, adverse effects and length of stay.

resultsNine trials, consisting of six studies comparing local versus regional anaesthesia and three comparing LA versus general anaesthesia, were included. Meta-analysis showed a significantly lower relative risk for need of rescue analgesia (RR 0.32 [95% CI 0.16-0.62]), intra-operative hypotension (RR 0.17 [95% CI 0.04-0.76]), headache (RR 0.13 [0.02-0.67]) and urinary retention (RR 0.17 [95% CI 0.09-0.29]) for LA when compared with regional anaesthesia. There was mixed evidence for both regional and general anaesthesia in regard to post-operative pain.

conclusionsLA alone may be considered as an alternative to regional anaesthesia for excisional haemorrhoidectomy with reduced complications and reduction in the amount of post-operative analgesia required. The evidence for LA compared to general anaesthesia for haemorrhoidectomy is low grade and mixed.

Indexed as

Anesthesia, GeneralAnesthesia, LocalHemorrhoidectomyHemorrhoidsHumansPain ManagementPostoperative Pain

Identifiers

PMID32383052
OpenAlexW3022268730

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.