Meta-analysis and trial sequential analysis of randomized evidence comparing general anesthesia vs regional anesthesia for laparoscopic cholecystectomy

Table 1 Summary characteristics of included studies

Ref.	Year	Country	Journal	Design	Total number of patients	GA	RA
Majedi et al[15]	2019	Iran	Advanced Biomedical Research	RCT	80	40	40
Sharaf et al[19]	2018	Pakistan	Anaesthesia, Pain and Intensive Care	RCT	120	60	60
Donmez et al[11]	2017	Turkey	Annals of Surgical Treatment and Research	RCT	49	25	24
Kalaivani et al[14]	2014	India	Journal of Clinical and Diagnostic Research	RCT	50	25	25
Prasad et al[17]	2014	India	Journal of Evolution of Medical and Dental Sciences	RCT	60	30	30
Ellakany et al[12]	2013	Egypt	Egyptian Journal of Anaesthesia	RCT	40	20	20
Tiwari et al[20]	2013	India	Journal of Minimal Access Surgery	RCT	235	114	110
Bessa et al[5]	2012	Egypt	Journal of Laparoendoscopic and Advanced Surgical Techniques	RCT	180	90	90
Ross et al[18]	2012	United States	Surgical Endoscopy	RCT	20	10	10
Mehta et al[16]	2010	India	Anesthesia, Essays and Researches	RCT	60	30	30
Imbelloni et al[13]	2010	Brazil	Revista Brasileira de Anestesiologia	RCT	68	33	35
Bessa et al[21]	2010	Egypt	Journal of Laparoendoscopic and Advanced Surgical Techniques	RCT	60	30	30
Tzovaras et al[4]	2008	Greece	Archives of Surgery	RCT	100	50	50

RCT: Randomized controlled trial; GA: General anesthesia; RA: Regional anesthesia.

Table 2 Demography and clinical characteristics of the patients

Ref.	Age		Male:female ratio		BMI		ASA I: II: III
	GA	RA	GA	RA	GA	RA	GA	RA
Majedi et al[15]	50.1 ± 9.78	52.06 ± 15.03	14:26	16:24	NR	NR	NR	NR
Sharaf et al[19]	44.07 ± 5.62	42.57 ± 5.77	0:60	0:60	25.41 ± 2.36	26 ± 2.31	14:46:0	22:38:0
Donmez et al[11]	45 ± 13	45 ± 14	18:07	18:6	28.75 ± 4.5	30.63 ± 3.6	18:7:0	16:6:2
Kalaivani et al[14]	47.84 ± 10.49	45 ± 11.73	08:17	10:15	NR	NR	NR	NR
Prasad et al[17]	38.5 ± 9.83	35.06 ± 7.5	25:5	17:13	23.5 ± 1.98	22.96 ± 2.98	23:7:0	22:8:0
Ellakany et al[12]	44.3 ± 13.2	45.9 ± 13.6	07:13	8:12	30 ± 3.9	29.8 ± 4.1	NR	NR
Tiwari et al[20]	46.1 ± 12.9	45.07 ±13.19	16:98	13:96	NR	NR	NR	NR
Bessa et al[5]	44 (19-50)	40 (16-50)	8:82	11:79	29.1 (23.4-33.1)	28.7 (22.8-34)	NR	NR
Ross et al[18]	39.4 ± 11.7	44.9 ± 12.5	3:7	2:8	25.1 ± 4.6	26.1 ± 5.5	1:6:3	3:5:2
Mehta et al[16]	38.3	39.1	10:20	14:16	NR	NR	NR	NR
Imbelloni et al[13]	45.2 ± 12.1	41.1 ± 12.4	10:23	9:26	NR	NR	NR	NR
Bessa et al[21]	40.9 ± 11	41.4 ± 11.1	6:24	5:25	30.8 ± 6.6	31.3 ± 4.1	NR	NR
Tzovaras et al[4]	46 (26-65)	44 (23-65)	18:30	20:29	26 (19-30)	25 (18-30)	37:11:0	40:9:0

GA: General anesthesia; RA: Regional anesthesia; NR: Not reported; ASA: American Society of Anesthesiologists; BMI: Body mass index.

Table 3 Anesthetic agents used in the regional anesthesia group in each study

Ref.	Anesthetic agent used
Majedi et al[15]	18 mL of lidocaine 2% plus epinephrine (1:200000) plus 2 mL of sodium bicarbonate 8.4% and fentanyl 50 µg
Sharaf et al[19]	15 mg of hyperbaric bupivicaine and 25 µg fentanyl
Donmez et al[11]	hyperbaric bupivicaine 16mg and fentanyl 10 micrograms
Kalaivani et al[14]	15 mg of hyperbaric bupivicaine and 20 µg fentanyl
Prasad et al[17]	15 mg of heavy bupivicaine and 25 µg fentanyl
Ellakany et al[12]	5 mg plain bupivicaine and 25 µg fentanyl
Tiwari et al[20]	12.5 mg to 17.5 mg of hyperbaric bupivicaine
Bessa et al[5]	15 mg of hyperbaric bupivicaine and 20 mcg fentanyl
Ross et al[18]	20-25 mL of lidocaine 2%
Mehta et al[16]	0.3 mg/kg of hyperbaric bupivicaine 0.5%
Imbelloni et al[13]	15 mg of hyperbaric bupivicaine and 20 µg fentanyl
Bessa et al[21]	15 mg of hyperbaric bupivicaine and 20 µg fentanyl
Tzovaras et al[4]	15 mg of hyperbaric bupivicaine, 0.25 mg morphine and 20 µg fentanyl