title: In children undergoing umbilical hernia repair is rectus sheath block effective at reducing post-operative pain? Best evidence topic (bet).
abstract: A best evidence topic was constructed according to a structured protocol. The question addressed was: In children undergoing umbilical hernia repair is a rectus sheath block (RSB) better than local anaesthetic infiltration of the surgical site, at reducing post-operative pain? From a total of 34 papers, three studies provided the best available evidence on this topic. One randomised clinical trial showed RSB had a better analgesic effect in the immediate post-operative period. In another randomised trial opioid consumption in the peri-operative period was found to be significantly lower in patients administered RSB. These improvements in pain and analgesia consumption need to be balanced against the expertise, training, equipment required, time implications and complications of performing a RSB.
authors.affiliation: Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Eastern Road, Brighton BN2 5BE, UK. Electronic address: kapilrajwani@hotmail.com.
authors.forename: Kapil M
authors.initials: KM
authors.lastname: Rajwani
authors.affiliation: Royal Sussex County Hospital, Eastern Road, Brighton BN2 5BE, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Butler
authors.affiliation: Department of Paediatric Surgery, Royal Alexandra Children's Hospital, Eastern Road, Brighton BN2 5BE, UK.
authors.forename: Anies
authors.initials: A
authors.lastname: Mahomed
mesh_terms: D000698:Analgesia / Q000009:adverse effects / Q000379:methods; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000772:Anesthesia, Local / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D005260:Female; D006554:Hernia, Umbilical / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D009186:Myelin Sheath; D009407:Nerve Block / Q000379:methods*; D059408:Pain Management; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D017568:Rectus Abdominis / Q000294:innervation*
chemical_list: D000701:Analgesics, Opioid
keywords: Paediatric regional anaesthesia; Rectus sheath block; Umbilical hernia repair