AUTHOR=Lu Haixia , Cai Min , Zhou Dongxi , Li Weiwei , Cao Hanzhong 

TITLE=The effect of bupivacaine on analgesia and safety in patients undergoing hemorrhoidectomy: a meta-analysis

JOURNAL=Frontiers in Pharmacology

VOLUME=14

YEAR=2024

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1331965

DOI=10.3389/fphar.2023.1331965

ISSN=1663-9812

ABSTRACT=<p><bold>Aim:</bold> There is no meta-analysis reporting the analgesic effect and safety of bupivacaine in patients undergoing hemorrhoidectomy. This meta-analysis provides quantitative evidence of the effect of bupivacaine in hemorrhoidectomy.</p><p><bold>Methods:</bold> Studies were searched from PubMed, Embase, the Cochrane Library, and the Web of Science. Standardized mean difference (SMD), weighted mean difference (WMD), and odds ratios (ORs) with 95% confidence interval (CI) were used as effect indicators. Heterogeneity was assessed using the <italic>I</italic><sup>2</sup> index, and sensitivity analysis was conducted to determine the effect of the single study on the pooled results.</p><p><bold>Results:</bold> A total of 18 studies were included in this meta-analysis. The pain level at 48 h was lower in the bupivacaine-combined other drug group than in the other drug group (WMD = −0.65, 95% CI: 1.18 to −0.11, and I<sup>2</sup> = 37.50%). Compared to the bupivacaine group, the odds of pruritus (OR = 12.11, 95% CI: 1.49–98.59, and I<sup>2</sup> = 0%) and urinary retention (OR = 4.45, 95% CI: 1.12–17.70, and I<sup>2</sup> = 0%) were higher, and the pain level at 6 h (WMD = −2.13, 95% CI: 3.22 to −1.04, and I<sup>2</sup> = 64.30%), at 12 h (WMD = −1.55, 95% CI: 2.19 to −0.90, and I<sup>2</sup> = 56.10%), and at 24 h (SMD = −1.15, 95% CI: 1.89 to −0.42, and I<sup>2</sup> = 82.5%) were lower in the bupivacaine-combined other drug group.</p><p><bold>Conclusion:</bold> Bupivacaine-combined other drugs had a good analgesic effect after hemorrhoidectomy, but the adverse reactions should be considered.</p>