Regional anaesthesia and chronic postsurgical pain: a systematic review and network meta-analysis.
Martin Taylor-Rowan, Iain Mactier, Clareece Nevill et al.
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In 30 seconds
This systematic review and network meta-analysis evaluated the impact of regional anaesthesia on chronic postsurgical pain (CPSP) in 18,794 subjects across 158 randomised controlled trials. The study found that regional anaesthesia significantly reduced the incidence of CPSP compared to no block (risk ratio: 0.73, 95% CI: 0.67-0.80), with effects lasting up to 12 months post-surgery.
Key findings
- Regional anaesthesia reduced CPSP incidence compared to no block (RR: 0.73, 95% CI: 0.67-0.80).
- Specific surgeries showed reduced CPSP: mastectomy (RR: 0.69), thoracotomy (RR: 0.72), and knee arthroplasty (RR: 0.71).
- Neuraxial techniques were more effective than peripheral techniques in reducing CPSP after thoracotomy and video-assisted thoracoscopic surgery.
- Opioid use did not significantly differ between groups (RR: 0.88, 95% CI: 0.61-1.28).
Why it matters
Chronic postsurgical pain is a significant concern for patients and healthcare providers. Understanding the role of regional anaesthesia in reducing CPSP can inform surgical pain management strategies and potentially improve patient outcomes.
What to keep in mind
The certainty of evidence regarding CPSP was low, and very low for opioid use, indicating potential limitations in the findings.