Rectus sheath block for postoperative analgesia in abdominal surgery: A systematic review and meta-analysis of randomized controlled trials.
- 1Department of Surgical and Interventional Sciences, McGill University Health Center, Montreal, QC, Canada.
- 2Department of Anesthesia, McGill University, Montreal, QC, Canada.
Abstract
The rectus sheath block is a potentially effective regional anesthetic technique for postoperative analgesia. However, evidence regarding its effectiveness across different surgical approaches and comparator techniques has remained inconsistent. We conducted a meta-analysis to evaluate the postoperative analgesic effectiveness of the rectus sheath block in abdominal surgery. Our study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In October 2025, we searched four databases (PUBMED, OVID Medline, SCOPUS, and Web of Science) for randomized controlled trials assessing the analgesic efficacy of the rectus sheath block following abdominal surgery. The primary outcomes were pain scores at rest measured at 0-2, 10-12, and 12-24 hours postoperatively. The secondary outcome was postoperative 24-hour intravenous morphine-equivalent consumption. Thirty-one randomized controlled trials involving 1076 participants who received the rectus sheath block and 1,065 who received alternative analgesic care were included. The rectus sheath block significantly reduced postoperative pain at 0-2 hours (mean difference [MD], -1.46, 95% CI, [ -2.26 to -0.66]; P < 0.001), 10-12 hours (MD, -0.94, 95% CI, [ -1.40 to -0.48]; P < 0.001), and 12-24 hours (MD, -0.65, 95% CI, [ -1.07 to -0.23]; P = 0.002). Twenty four-hour intravenous morphine-equivalent consumption was significantly lower with the rectus sheath block (MD, -7.40, 95% CI, [ -11.86 to -2.94]; P = 0.001). Rectus sheath block was associated with reduced postoperative pain scores and reduced opioid use in the first 24 hours after abdominal surgery. Clinical trial registration: CRD420251208643 (PROSPERO).
Related
- Anterior Quadratus Lumborum Block for Postoperative Analgesia in Hip Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with Trial Sequential Analysis
- Effects of different doses of esketamine as an adjunct to sufentanil-based patient-controlled intravenous analgesia on postoperative analgesia and opioid consumption following lumbar decompression surgery: a dose-finding randomized controlled trial
- Erector spinae plane block added to intercostal nerve block versus intercostal nerve block alone for postoperative analgesia in video-assisted thoracoscopic surgery: A randomized controlled trial
- Bilateral Erector Spinae Plane Block With 0.375% Ropivacaine and Postoperative Analgesia After Laparoscopic Cholecystectomy: A Prospective, Randomized, Controlled Cohort Study.
- Non-Inferiority Margins in Randomized Controlled Trials in Abdominal Surgery- a Systematic Review
BibTeX
@article{rispler2026rectus,
title = {{Rectus sheath block for postoperative analgesia in abdominal surgery: A systematic review and meta-analysis of randomized controlled trials.}},
author = {Emma L Rispler and Sean D Jeffries and Robert Harutyunyan and Avinash Sinha and Thomas M Hemmerling},
journal = {Saudi journal of anaesthesia},
year = {2026},
month = oct,
doi = {10.4103/sja.sja_266_26},
url = {https://europepmc.org/article/MED/42960035},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Rectus sheath block for postoperative analgesia in abdominal surgery: A systematic review and meta-analysis of randomized controlled trials.
AU - Emma L Rispler
AU - Sean D Jeffries
AU - Robert Harutyunyan
AU - Avinash Sinha
AU - Thomas M Hemmerling
PY - 2026
DA - 2026/10/01
JO - Saudi journal of anaesthesia
DO - 10.4103/sja.sja_266_26
UR - https://europepmc.org/article/MED/42960035
AB - The rectus sheath block is a potentially effective regional anesthetic technique for postoperative analgesia. However, evidence regarding its effectiveness across different surgical approaches and comparator techniques has remained inconsistent. We conducted a meta-analysis to evaluate the postoperative analgesic effectiveness of the rectus sheath block in abdominal surgery. Our study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In October 2025, we searched four databases (PUBMED, OVID Medline, SCOPUS, and Web of Science) for randomized controlled trials assessing the analgesic efficacy of the rectus sheath block following abdominal surgery. The primary outcomes were pain scores at rest measured at 0-2, 10-12, and 12-24 hours postoperatively. The secondary outcome was postoperative 24-hour intravenous morphine-equivalent consumption. Thirty-one randomized controlled trials involving 1076 participants who received the rectus sheath block and 1,065 who received alternative analgesic care were included. The rectus sheath block significantly reduced postoperative pain at 0-2 hours (mean difference [MD], -1.46, 95% CI, [ -2.26 to -0.66]; P < 0.001), 10-12 hours (MD, -0.94, 95% CI, [ -1.40 to -0.48]; P < 0.001), and 12-24 hours (MD, -0.65, 95% CI, [ -1.07 to -0.23]; P = 0.002). Twenty four-hour intravenous morphine-equivalent consumption was significantly lower with the rectus sheath block (MD, -7.40, 95% CI, [ -11.86 to -2.94]; P = 0.001). Rectus sheath block was associated with reduced postoperative pain scores and reduced opioid use in the first 24 hours after abdominal surgery. Clinical trial registration: CRD420251208643 (PROSPERO).
SN - 1658-354X
SN - 0975-3125
ER -