{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:58:20Z","timestamp":1791446300221,"version":"4.3.3"},"reference-count":108,"publisher":"The Korean Society of Anesthesiologists","issue":"1","license":[{"start":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T00:00:00Z","timestamp":1667865600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ekja.org"],"crossmark-restriction":true},"short-container-title":["Korean J Anesthesiol"],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:p>Background: Different regional anesthesia (RA) techniques have been used for laparoscopic cholecystectomy (LC), but there is no consensus on their comparative effectiveness. Our objective was to evaluate the effect of RA techniques on patients undergoing LC using a network meta-analysis approach.Methods: We conducted a systematic review and network meta-analysis. We searched PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science (Science and Social Science Citation Index) using the following PICOS criteria: (P) adult patients undergoing LC; (I) any RA single-shot technique with injection of local anesthetics; (C) placebo or no intervention; (O) postoperative opioid consumption expressed as morphine milligram equivalents (MME), rest pain at 12 h and 24 h post-operation, postoperative nausea and vomiting (PONV), length of stay; and (S) randomized controlled trials.Results: A total of 84 studies were included. With the exception of the rectus sheath block (P = 0.301), the RA techniques were superior to placebo at reducing opioid consumption. Regarding postoperative pain, the transversus abdominis plane (TAP) block (\u22121.80 on an 11-point pain scale) and erector spinae plane (ESP) block (\u22121.33 on an 11-point pain scale) were the most effective at 12 and 24 h. The TAP block was also associated with the greatest reduction in PONV.Conclusions: RA techniques are effective at reducing intraoperative opioid use, postoperative pain, and PONV in patients undergoing LC. Patients benefit the most from the bilateral paravertebral, ESP, quadratus lumborum, and TAP blocks.<\/jats:p>","DOI":"10.4097\/kja.22366","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T00:35:15Z","timestamp":1667867715000},"page":"34-46","update-policy":"https:\/\/doi.org\/10.4097\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Single-shot regional anesthesia for laparoscopic cholecystectomies: a systematic review and network meta-analysis"],"prefix":"10.4097","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9773-1832","authenticated-orcid":true,"given":"Alessandro","family":"De Cassai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9338-4995","authenticated-orcid":true,"given":"Nicol\u00f2","family":"Sella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1837-0662","authenticated-orcid":true,"given":"Federico","family":"Geraldini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1996-7505","authenticated-orcid":true,"given":"Serkan","family":"Tulgar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8467-8171","authenticated-orcid":true,"given":"Ali","family":"Ahiskalioglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4562-1172","authenticated-orcid":true,"given":"Burhan","family":"Dost","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1052-4823","authenticated-orcid":true,"given":"Silvia","family":"Manfrin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9996-8756","authenticated-orcid":true,"given":"Yunus Emre","family":"Karapinar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9421-1834","authenticated-orcid":true,"given":"Greta","family":"Paganini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9623-5418","authenticated-orcid":true,"given":"Muzeyyen","family":"Beldagli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3812-0396","authenticated-orcid":true,"given":"Vittoria","family":"Luoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9403-724X","authenticated-orcid":true,"given":"Busra Burcu Kucuk","family":"Ordulu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3409-4159","authenticated-orcid":true,"given":"Annalisa","family":"Boscolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3733-3453","authenticated-orcid":true,"given":"Paolo","family":"Navalesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2573","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-021-08316-1"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.700318"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i46.17626"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1177\/107155170401100107"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/s0304-3959(00)00406-1"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2011.597"},{"key":"ref7","first-page":"185","volume-title":"Ultrasound-guided oblique subcostal transversus abdominis plane block for analgesia after laparoscopic cholecystectomy: a randomized, controlled, observer-blinded study","author":"Shin","year":"2014"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0000000000000545"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12953"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2021.110450"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9092928"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-5019-2"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2020.12.003"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g5630"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-015-0060-8"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007\/bf00316685"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2000.440806.x"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1017\/s0265021503001431"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199511000-00013"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2021.106134"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199607000-00003"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1097\/00129689-200012000-00003"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1007\/s00101-021-01015-5"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1016\/j.rapm.2004.05.009"},{"key":"ref29","first-page":"121","volume-title":"Postoperative pain relief after laparoscopic cholecystectomy: a randomised prospective double-blind clinical trial","author":"Lepner","year":"2003"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2019.03.012"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2016.03.033"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.14196\/mjiri.32.112"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1995.tb04042.x"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.29271\/jcpsp.2018.09.663"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2021.110403"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.4103\/aer.aer_41_20"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-002-9256-1"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.1007\/s004640000294"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.4103\/ija.ija_55_18"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.4103\/aer.aer_205_17"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.4103\/aer.aer_157_17"},{"key":"ref42","first-page":"12","volume-title":"Analgesic effect of bilateral subcostal tap block after laparoscopic cholecystectomy","author":"Khan","year":"2018"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.5505\/agri.2018.45822"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0b013e318261f16e"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1997.tb04664.x"},{"key":"ref46","doi-asserted-by":"publisher","DOI":"10.1016\/s1366-0071(00)90005-6"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.4103\/0972-9941.83508"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2000.440310.x"},{"key":"ref49","doi-asserted-by":"publisher","DOI":"10.7860\/jcdr\/2016\/18845.8309"},{"key":"ref50","first-page":"284","volume-title":"Randomized, controlled trial of bupivacaine injection to decrease pain after laparoscopic cholecystectomy","author":"Dath","year":"1999"},{"key":"ref51","doi-asserted-by":"publisher","DOI":"10.4103\/1658-354x.168821"},{"key":"ref52","first-page":"12","volume-title":"The efficacy of oblique subcostal transversus abdominis plane block in laparoscopic cholecystectomy - a prospective, placebo controlled study","author":"Breazu","year":"2016"},{"key":"ref53","doi-asserted-by":"publisher","DOI":"10.4103\/0259-1162.164731"},{"key":"ref54","first-page":"22460","volume-title":"Combined usage with intraperitoneal and incisional ropivacaine reduces pain severity after laparoscopic cholecystectomy","author":"Liu","year":"2015"},{"key":"ref55","first-page":"13824","volume-title":"Comparison of bupivacaine and parecoxib for postoperative pain relief after laparoscopic cholecystectomy: a randomized controlled trial","author":"Lin","year":"2015"},{"key":"ref56","doi-asserted-by":"publisher","DOI":"10.1186\/s13037-015-0077-2"},{"key":"ref57","doi-asserted-by":"publisher","DOI":"10.1016\/j.aat.2015.07.003"},{"key":"ref58","first-page":"274","volume-title":"[Locally administered ropivacaine vs. standard analgesia for laparoscopic cholecystectomy] [Article in Spanish]","author":"Chavarr\u00eda-P\u00e9rez","year":"2015"},{"key":"ref59","doi-asserted-by":"publisher","DOI":"10.12659\/msm.893593"},{"key":"ref60","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2018.06.019"},{"key":"ref61","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.14151"},{"key":"ref62","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/2815301"},{"key":"ref63","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2019.109696"},{"key":"ref64","doi-asserted-by":"publisher","DOI":"10.3325\/cmj.2021.62.137"},{"key":"ref65","doi-asserted-by":"publisher","DOI":"10.1080\/08941939.2021.1931574"},{"key":"ref66","doi-asserted-by":"publisher","DOI":"10.1007\/s004649910011"},{"key":"ref67","doi-asserted-by":"publisher","DOI":"10.1111\/ases.12178"},{"key":"ref68","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2014.11681004"},{"key":"ref69","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-018-6053-z"},{"key":"ref70","doi-asserted-by":"publisher","DOI":"10.4103\/aer.aer_100_20"},{"key":"ref71","doi-asserted-by":"publisher","DOI":"10.1111\/ases.12957"},{"key":"ref72","doi-asserted-by":"publisher","DOI":"10.4103\/joacp.joacp_358_19"},{"key":"ref73","doi-asserted-by":"publisher","DOI":"10.14744\/agri.2020.60487"},{"key":"ref74","first-page":"1106","volume-title":"Comparison of analgesic efficacy of transversus abdominis plane block with conventional local anesthetic wound infiltration","author":"Ali","year":"2018"},{"key":"ref75","doi-asserted-by":"publisher","DOI":"10.1097\/00003643-200408000-00011"},{"key":"ref76","doi-asserted-by":"publisher","DOI":"10.1097\/aap.0b013e318244851b"},{"key":"ref77","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2013.11.023"},{"key":"ref78","doi-asserted-by":"publisher","DOI":"10.1007\/s00101-020-00746-1"},{"key":"ref79","doi-asserted-by":"publisher","DOI":"10.4103\/aer.aer_3_19"},{"key":"ref80","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1427"},{"key":"ref81","doi-asserted-by":"publisher","DOI":"10.1089\/lps.1994.4.405"},{"key":"ref82","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/72.3.263"},{"key":"ref83","doi-asserted-by":"publisher","DOI":"10.1097\/eja.0000000000001028"},{"key":"ref84","doi-asserted-by":"publisher","DOI":"10.4097\/kjae.2010.58.4.362"},{"key":"ref85","first-page":"344","volume-title":"Intraperitoneal administration of 50% enantiomeric excess (S75 - R25) bupivacaine in postoperative analgesia of laparoscopic cholecystectomy] [Article in Portuguese]","author":"Garcia","year":"2007"},{"key":"ref86","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-006-3408-1"},{"key":"ref87","doi-asserted-by":"publisher","DOI":"10.4103\/0259-1162.194561"},{"key":"ref88","doi-asserted-by":"publisher","DOI":"10.5152\/tjar.2016.75983"},{"key":"ref89","doi-asserted-by":"publisher","DOI":"10.5152\/tjar.2014.06025"},{"key":"ref90","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2014.12.034"},{"key":"ref91","doi-asserted-by":"publisher","DOI":"10.4103\/0259-1162.186620"},{"key":"ref92","doi-asserted-by":"publisher","DOI":"10.4103\/1658-354x.105860"},{"key":"ref93","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes495"},{"key":"ref94","doi-asserted-by":"publisher","DOI":"10.4293\/108680812x13291597716221"},{"key":"ref95","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-005-0284-5"},{"key":"ref96","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2018.06.027"},{"key":"ref97","doi-asserted-by":"publisher","DOI":"10.3109\/13645709509152758"},{"key":"ref98","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-200201000-00019"},{"key":"ref99","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-020-07558-9"},{"key":"ref100","doi-asserted-by":"publisher","DOI":"10.29271\/jcpsp.2020.01.09"},{"key":"ref101","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-005-3002-4"},{"key":"ref102","first-page":"316","volume-title":"Intraperitoneal and intravenous routes for pain relief in laparoscopic cholecystectomy","author":"Jabbour-Khoury","year":"2005"},{"key":"ref103","doi-asserted-by":"publisher","DOI":"10.1007\/s004640090124"},{"key":"ref104","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.06.023"},{"key":"ref105","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2020-101917"},{"key":"ref106","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2020-101670"},{"key":"ref107","first-page":"379","volume-title":"Pain after laparoscopic cholecystectomy: characteristics and effect of intraperitoneal bupivacaine","author":"Joris","year":"1995"},{"key":"ref108","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1995.tb01787.x"}],"container-title":["Korean Journal of Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ekja.org\/upload\/pdf\/kja-22366.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ekja.org\/journal\/view.php?doi=10.4097\/kja.22366","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ekja.org\/upload\/pdf\/kja-22366.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T23:29:58Z","timestamp":1675207798000},"score":1,"resource":{"primary":{"URL":"http:\/\/ekja.org\/journal\/view.php?doi=10.4097\/kja.22366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,1]]},"references-count":108,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2]]}},"URL":"https:\/\/doi.org\/10.4097\/kja.22366","relation":{},"ISSN":["2005-6419","2005-7563"],"issn-type":[{"value":"2005-6419","type":"print"},{"value":"2005-7563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,1]]},"assertion":[{"value":"2022-06-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-08","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}