Objective  To systematically review the efficacy and safety of multimodal analgesis (MMA) in hepatectomy patients with liver cancer.

Methods  Randomized controlled trials (RCTs) on the application of multimodal analgesis in patients with hepatocellular carcinoma were searched electronically from CBM, Wanfang Data, CNKI, VIP, PubMed, The Cochrane Library, Web of Science, and EMbase from inception of the databases to June 2022. Two researchers independently reviewed the literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was performed by RevMan 5.4 software.

Results  A total of 11 RCTs were included, involving 916 patients with liver cancer. Meta-analysis results indicated that, compared to the control group, the postoperative pain scores at 12 h [SMD=-1.57, 95%CI(-1.90, -1.25), P<0.001], 24 h [SMD=-1.57, 95%CI(-2.04, -1.11), P<0.001] and 48 h[SMD=-1.09, 95%CI(-1.48, -0.69), P<0.01], the first postoperative exhaust time [MD=-6.21, 95%CI(-8.15, -4.26), P<0.01], the hospital stay [MD=-3.36, 95%CI(-3.63, -3.09), P<0.01], and the incidence of postoperative adverse reactions [RR=0.65, 95%CI(0.50, 0.85), P<0.01] in the experimental group were lower.

Conclusion  MMA can effectively alleviate the postoperative pain in hepatectomy patients with liver cancer, promote the recovery of gastrointestinal function, reduce the occurrence of postoperative adverse reactions, shorten the hospitalization time, and promote the rapid recovery.

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