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Ropivacaine Versus Bupivacaine in Pediatric Tonsillectomy: A Systematic Review and Meta-Analysis.
Review in OTO open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: To evaluate the analgesic efficacy and safety of local anesthetic infiltration in the tonsillar fossa using ropivacaine compared to bupivacaine in pediatric patients undergoing tonsillectomy. Data Sources: CENTRAL, PubMed, Web of Science, Scopus, and Google Scholar. Review Methods: Eligible randomized controlled trials (RCTs) were evaluated for risk of bias using Cochrane's Risk of Bias Tool (RoB-2). The primary outcome was postoperative pain within the first 24 hours following tonsillectomy. Secondary outcomes included the time to first analgesic requirement and complication rates (ie, bleeding, airway obstruction, local anesthetic toxicity, and nausea). Data were synthesized using the standardized mean difference (SMD) for continuous outcomes and risk ratio (RR) for dichotomous outcomes, both reported with 95% confidence intervals (CI). Results: Seven RCTs with a total of 375 patients were analyzed. Regarding posttonsillectomy pain scores, there was no significant difference between ropivacaine and bupivacaine at 1 hour (SMD = -0.01, 95% confidence interval [CI] [-0.36, 0.34]), 2 hours (SMD = 0.03, 95% CI [-0.45, 0.51]), 4 hours (SMD = -0.17, 95% CI [-0.39, 0.06]), 6-8 hours (SMD = 0.04, 95% CI [-0.38, 0.46]), and 12 hours (SMD = -0.23, 95% CI [-0.62, 0.15]). However, at 24 hours, ropivacaine demonstrated a superior effect compared to bupivacaine (SMD = -0.23, 95% CI [-0.43, -0.03]). There was no significant difference between ropivacaine and bupivacaine in terms of time to first analgesia and complication rates ( Conclusion: This meta-analysis demonstrated that ropivacaine and bupivacaine offer comparable clinical analgesic efficacy and safety profiles in pediatric patients undergoing tonsillectomy.
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