{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T17:45:49Z","timestamp":1776015949162,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative pain after bariatric surgery is a significant clinical challenge, with approximately 61.4% of patients reporting persistent pain. Intraperitoneal local anesthetic instillation (IPLA) has been proposed as a strategy to reduce pain and opioid\u2010related adverse effects. However, as its effectiveness in bariatric procedures remains controversial, this meta\u2010analysis was conducted to clarify the role of IPLA in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta\u2010analysis was conducted following PRISMA guidelines and was prospectively registered in PROSPERO. We performed a comprehensive search in Pubmed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science for randomized controlled trials (RCTs) IPLA instillation with a control group in patients undergoing bariatric surgery. The primary outcomes were postoperative pain intensity, need for rescue analgesia, and supplementary opioid consumption. Secondary outcomes included postoperative nausea and vomiting (PONV), nausea, vomiting, and shoulder pain. Data were synthesized using a random\u2010effects model to calculate Risk Ratios (RR) for binary outcomes and Standardized Mean Differences (SMD) and Mean Differences (MD) for continuous outcomes. The methodological quality of the trials was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The analysis included 13 randomized controlled trials with a total of 1205 participants, of whom 624 were in the intraperitoneal local anesthetic (IPLA) group and 581 were in the control group. The pooled results showed that IPLA significantly reduced postoperative pain intensity (SMD: \u22120.96, 95% CI \u22121.72 to \u22120.20;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01) and the need for rescue analgesia (RR: 0.52, 95% CI 0.31\u20130.89). However, there was no significant difference in postoperative opioid consumption (SMD: \u22120.56, 95% CI \u22121.13 to 0.01;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.05). Additionally, no significant effects were found for the incidence of postoperative nausea and vomiting (PONV) or shoulder pain. High heterogeneity was noted in most of the analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IPLA reduces postoperative pain in bariatric surgery but does not decrease opioid consumption or adverse events. A suggested reduction in rescue analgesia was not robust. Due to high heterogeneity, the findings' clinical applicability is limited, highlighting the need for standardized trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trail Registration<\/jats:title>\n                    <jats:p>PROSPERO protocol CRD420251085223\u2014July 2025<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70296","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T04:37:16Z","timestamp":1773722236000},"page":"785-795","source":"Crossref","is-referenced-by-count":0,"title":["Intraperitoneal Local Anesthetic Instillation for Post\u2010Operative Pain Control After Bariatric Surgery: A Systematic Review and Meta\u2010Analysis of Randomized Controlled Trials"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3473-9887","authenticated-orcid":false,"given":"Breno Dias L.","family":"Ribeiro","sequence":"first","affiliation":[{"name":"Department of Medicine Federal University of Maranh\u00e3o  S\u00e3o Lu\u00eds Maranh\u00e3o Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5689-9236","authenticated-orcid":false,"given":"Italo C.","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Medicine Federal University of Maranh\u00e3o  S\u00e3o Lu\u00eds Maranh\u00e3o Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7514-1600","authenticated-orcid":false,"given":"Maria J\u00falia de Sena","family":"Lopes","sequence":"additional","affiliation":[{"name":"Department of Medicine Federal University of Maranh\u00e3o  S\u00e3o Lu\u00eds Maranh\u00e3o Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9948-2845","authenticated-orcid":false,"given":"Luis Eduardo Rodrigues","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Medicine Federal University of Maranh\u00e3o  S\u00e3o Lu\u00eds Maranh\u00e3o Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7081-5043","authenticated-orcid":false,"given":"Maciel da Silva","family":"Cassiano","sequence":"additional","affiliation":[{"name":"Department of Medicine S\u00e3o Domingos Hospital  S\u00e3o Lu\u00eds Maranh\u00e3o Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5555-5445","authenticated-orcid":false,"given":"Ronainy Francieli Silva","family":"Matos","sequence":"additional","affiliation":[{"name":"Department of Medicine Federal University of Maranh\u00e3o  S\u00e3o Lu\u00eds Maranh\u00e3o Brazil"},{"name":"Department of Medicine S\u00e3o Domingos Hospital  S\u00e3o Lu\u00eds Maranh\u00e3o 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