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Table 1 Characteristics of the published randomized controlled trails presented with respect to type of surgery

From: Post-operative pain management modalities employed in clinical trials for adult patients in LMIC; a systematic review

Authors Country Age Range Gender N Groups N Modalities Studied Pain Assessment Tool Modalities
used
Duration of post-operative Pain studied Rescue Analgesia
Bhatia et al., (2014) [12] India 18–60 Both 60 3 20 Ultrasound-guided posterior transversus abdominis plane (TAP) block with 15 mL of 0.375% ropivacaine VAS
(Visual Analogue Scale)
Single 24 h Tramadol
      20 Ultrasound-guided subcostal TAP block with 15 mL of 0.375% ropivacaine     
      20 Control     
Shukla et al.,(2015) [13] India 18–60 Both 120 3 40 Intraperitoneal bupivacaine 50 ml 0.25% + 5 ml Normal saline VAS Single 24 h Diclofenac
      40 Bupivacaine 50 ml 0.25% + tramadol 1 mg/kg (diluted in 5 ml NS)     
      40 Bupivacaine 50 ml 0.25% + dexmedetomidine 1 μg/kg, (diluted in 5 ml NS)     
Sinha et al., (2016) [14] India 18–65 Both 60 2 30 TAP block with 0.25% Bupivacaine VAS Single 24 h Diclofenac
      30 TAP block with 0.375% Ropivacaine     
Kamhawy et al., (2017) [15] Egypt 21–60 Both 46 2 23 Unilateral subcostal TAP block VAS Multi 24 h PCA Morphine
      23 Unilateral thoracic paravertebral block     
Saxena et al., (2016) [16] India 18–70 Both 80 2 40 Local anesthetic infiltration of surgical incision NRS
(Numerical rating score)
Multi 24 h Fentanyl
      40 Bilateral rectus sheath and right TAP blocks     
Ali et al., (2012) [17] Pakistan 35–65 Both 60 2 30 Oral pregablin 150 mg VAS Single 24 h Nalbuphine
      30 Oral celecoxib 200 mg     
Suseela et al., (2018) [18] India 20–65 Both 80 2 40 Bilateral ultrasound-guided subcostal TAP block with 20 mL of 0.25% bupivacaine NRS Multi 24 h Tramadol Diclofenac
      40 Port-site infiltration with 20 mL of 0.5% bupivacaine     
Anand et al.,(2017) [19] India 20–60 Both 60 2 30 Alprazolam VAS Multi 24 h Tramadol
      30 Pregabalin     
Pasha et al., (2018) [20] Nowshera 18–65 Both 90 2 45 Gabapentin VAS Multi 24 h None
      45 Placebo     
Khan et al., (2018) [21] pakistan 18–60 Both 126 2 63 Posterior TAP block with 0.375% bupivacaine NRS Multi 24 h Tramadol
      63 subcostal TAP block with 0.375% bupivacaine     
Jain et al., (2018) [22] India 20–60 Both 60 2 30 Intraperitoneal Saline with 500 ml NRS single 24 h Tramadol
      30 Intraperitoneal Bupivacaine with 20 ml of 0.5% (100 mg)     
Amr et al., (2010) [23] Egypt 18+ Both 40 2 20 Preincisional thoracic epidural analgesia (TEA) VAS Single 24 h None
      20 End of surgery TEA     
Khalil et al., (2017) [24] Egypt 20–60 Both 40 2 20 Ultrasound-guided serratus anterior plane block VAS Multi 24 h Morphine
      20 TEA     
Dutta et al., (2017) [25] India 18–70 Both 30 2 15 Bolus of 15 mL of 0.75% ropivacaine over 3 to 5 min, followed by an infusion of 0.2% ropivacaine at 0.1 ml/kg/hour VAS Multi 24 h Morphine
      15 15 ml of 0.75% ropivacaine plus dexmedetomidine,1 mg/kg bolus over 3 to 5 minutesfollowed by an infusion of 0.2% ropivacaine plus 0.2 mg/kg/hour of dexmedetomidine at 0.1 ml/kg/hour.     
Biswas et al., (2016) [26] India 18–60 Both 60 2 30 Epidural: 7.5 ml bolus of 0.125% Bupivacaine with 50 μg Fentanyl VAS/ FPORS Muti 24 h Tramadol
      30 Paravertebral 15 ml bolus of 0.125% Bupivacaine with 50 μg Fentanyl     
Bakshi et al., (2016) [27] India 18–75 Female 71 2 36 Rectus sheath block with 0.25% bupivacaine NRS Multi 48 h Morphine
      35 Rectus sheath block with normal saline     
Dhanapal et al., (2014) [28] India 18+ Both 94 2 47 Wound infusion with Bupivacaine VAS Single 48 h Morphine
      47 Wound infusion with N saline     
Wahba et al., (2014) [29] Egypt 59–75 Both 44 2 22 Thoracic epidural infusion VRS Multi 48 h Morphine (PCA)
      22 Bilateral TAP block infusion with catheter     
Sethi et al., (2014) [30] India 18–45 Both 100 2 50 Patient controlled epidural analgesia (PCEA) with Ketamine + Morphine VAS Multiple 48 h Diclofenac
      50 PCEA Morphine     
Moawad et al., (2014) [31] Egypt 20–60 Both 100 2 50 PCEA Bupivacaine + Fentanyl NRS Multiple 24 h Fentanyl
      50 Intravenous patient controlled analgesia (PCA) with Fentanyl     
Patil et al., (2018) [32] India 18–65 Female 60 2 30 Thoracic epidural infusion with 0.125% Ropivacaine and Fentanyl
0.125% Bupivacaine and Fentanyl
VAS Multi 24 h Tramadol
      30      
Bharti et al., (2018) [33] India Adult patients Both 40 2 20 50 μg Dexmedetomidine with 10 ml of 0.125% Bupivacaine in thoracic epidural VAS Multi 24 h Diclofenac
      20 50 μg Fentanyl with 10 ml 0.125% Bupivacaine in thoracic epidural     
Alvi et al., (2017) [34] Pakistan 18–50 Both 200 2 100 TAP block NRS Single 24 h None
      100 Placebo block     
Patel et al., (2018) [35] India 20 to 65 Both 60 2 30 TAP block with Ropivacaine (0.5%) 20 ml VAS Multi 24 h Diclofenac
      30 Spinal anaesthesia     
Mishra et al., (2018) [36] India 18–60 Both 60 2 30 Thoracic paravertebral block (20 mL 0.25% bupivacaine) VAS Multi 24 h Tramadol
      30 IV PCA with fentanyl     
Bharti et al., (2011) [37] India 18–60 Both 40 2 20 TAP Block with 20 mL of 0.25% bupivacaine VAS Single 24 h Morphine
      20 TAP Block with Saline     
Chotton et al., (2014) [38] India 18–60 Female 90 2 45 Pregabalin 150 mg VAS Multi 24 h Ketorolac
      45 Placebo     
Badawy et al., (2015) [39] Egypt 40–70 Female 60 3 20
20
20
Oral gabapentin 800 mg
Gabapentin 800 mg + Dexamethasone 8 mg
Placebo
VAS Multi 24 h Meperidine
Bashandy et al., (2015) [40] Egypt Adult Female 120 2 60
60
Ultrasound-guided Pecs block
Control
VAS Single 24 h Morphine
Hetta et al., (2016) [41] Egypt Adult Female 111 4 28
27
26
30
Pregabalin 75 mg
Pregabalin 150 mg
Pregabalin 300 mg
Placebo Capsule
VAS Single 24 h Morphine
Kasimahanti et al.,(2016) [42] India 18–60 Female 58 2 28
30
Single-level, unilateral ultrasound-guided TPVB at T4 level using 0.3 mL/kg of 0.5% ropivacaine
Double-level, unilateral ultrasound-guided TPVB at T2 and T5 level using a total volume of 0.3 mL/kg of 0.5% ropivacaine
NRS Single 24 h Diclofenac
Kulhari et al., (2016) [43] India 18–65 Female 40 2 20 TPVB with ropivacaine 0.5%, 25 ml, VAS Single 24 h Morphine
      20 PECS II block with ropivacaine 0.5%     
Gupta et al., (2017) [44] India 18–65 Female 50 2 25 Paravertebral block VAS Multi 72 h PCA Morphine
      25 Serratus Plane block     
Bhuvaneswari et al.,(2012) [45] India Adult Female 48 4 12 Paravertebral block with 0.25% bupivacaine with epinephrine 5 mcg/ ml VAS Single 24 h Morphine
      12 Paravertebral block with 0.25% bupivacaine + epinephrine 5 mcg/ml with 2 mcg/ml fentanyl     
      12 Paravertebral block with 0.5% bupivacaine + epinephrine 5 mcg/ml or isotonic saline     
      12 Noraml Salin     
Mahran et al., (2015) [46] Egypt 18–65 Female 90 3 30 Pregabalin 150 mg oral VAS Multi 24 h Morphine
      30 Placebo capsule (oral) and 0.5 mg/kg ketamine IV     
      30 Placebo     
Kundra et al., (2013) [47] India Adult Female 120 2 60 Paravertebral block VAS Multi 24 h No rescue analgesia
      60 Interpleural block     
M. Neetu et al., (2018) [48] India 18–70 Female 60 2 30 PECS block VAS Multi 24 h None
      30 Placebo     
Mukherjee et al., (2018) [49] India 35–60 female 88 2 44 Ropivacaine (0.5%) VAS single 48 h Diclofenac
      44 Dexmedetomidine 1 μ/kg     
Megha et al., (2018) [50] India 18–60 Female 47 2 23 Paravertebral block with 20 ml bupivacaine 0.25% with morphine 3 mg NRS Multi 24 h Diclofenac
      24 Dexmedetomidine 1 μg/kg     
Manzoor et al., (2018) [51] India 18–70 Female 60 2 30 PECS I block with 30 ml 0.25% bupivacaine VAS single 24 h Diclofenac
      30 PECS I block with 10 ml 0.25% bupivacaine with dexmedetomidine     
Kumar et al., (2018) [52] India ? Female 50 2 25 Opioids and non-steroidal anti-inflammatory drug VAS Multi 24 h Tramadol
      25 PECS I with 0.25% bupivacaine     
Bharti et al., (2015) [53] India 20–60 Both 54 2 27 Supraclavicular block with 1 μg/kg of Dexmedetomidine along with equal volumes of 0.75% ropivacaine and 2% lidocaine with adrenaline. VAS Single 24 h Tramadol Diclofenac
      27 0.75% Ropivacaine and 2% Lidocaine with adrenaline (1:2,00,000)     
Kumar et al., (2014) [54] India 18–60 Both 30 2 15 Ultrasound-guided stellate ganglion block with 2% Lidocaine VAS Single 24 h PCIA Used [No Rescue]
      15 Ultrasound-guided stellate ganglion block with 0.9% Saline     
Mullaji et al., (2010) [55] India 50–80 Both 40 2 20 Combined spinal epidural + local anesthetic infiltration VAS Single 24 h None
      20 Combined spinal epidural with no local anesthetic infiltration     
Khanna et al., (2017) [56] India 40–60 Both 90 3 30 Epidural with ropivacaine 0.1% VAS Multi 36 h PCEA
      30 Epidural with ropivacaine 0.1% with fentanyl 2.5μg/mL     
      30 Epidural with ropivacaine 0.0625% with fentanyl 2.5μg/mL     
Anis et al., (2011) [57] Egypt 18–60 Both 60 3 20 Lumbar plexus block with 15 ml bupivacaine 0.25% + clonidine VAS Single 24 h Morphine
      20 Lumbar plexus block with bupivacaine 0.25% + clonidine     
      20 No Block     
Sawhney et al., (2015) [58] India Adult Both 100 4 25 Epidural with 0.2% Ropivacaine VAS Single 24 h Tramadol
      25 Epidural with0.1% Ropivacaine+Fentanyl 2 μg/ml     
      25 Epidural with 0.2% Bupivacaine     
      25 Epidural with Bupivacaine 0.1% with Fentanyl 2 μg/ml.     
Trabelsi et al., (2017) [59] Tunisia > 18 Both 60 2 30 Suprascapular block + supraclavicular block VAS Multi 24 h Morphine
      30 Interscalene block     
Meghana et al., (2017) [60] India 20–65 Both 70 2 35 0.125% bupivacaine and 2 mg/ml fentanyl epidural infusion NRS Single 48 h Tramadol
      35 0.2% ropivacaine and 2 mg/ml fentanyl as epidural infusion     
Thakur et al., (2015) [61] India 18–60 Both 67 3 22 Axillary brachial plexus block with bupivacine, lignocaine, adrenaline and buprenorphine + IM placebo VAS Single 24 h Diclofenac
      23 Axillary brachial plexus block with bupivacine, lignocaine, adrenaline and placebo + IM buprenorphine     
      22 Axillary brachial plexus block with bupivacine, lignocaine, adrenaline and placebo + IM placebo     
Mostafa et al., (2018) [62] Egypt 50–70 Both 60 2 30 Levobupivacaine 0.125% VAS Multi 24 h None
      30 IV fentanyl 20 μg/ml