A Systematic Review on Long-Term Postsurgical Pain Outcomes; What Is the Effect of Upper Extremity Regional Anesthesia?
An erratum to this article was published (Anesth Analg, 1 Nov 2023 ↗)
Authors' conclusion
The results of this review indicate that upper extremity regional anesthesia, compared to general anesthesia, is unlikely to change pain intensity at >3 months postoperatively.
Study context
- Population
- Patients undergoing elective upper extremity surgery14 studies
- Comparison
- Upper extremity RA vs GA
- Outcome
- Numerical rating score or visual analogue scale for pain
- Follow-up
- >3 months postoperatively
Methodological detailsGrading of Recommendations Assessment, Development and Evaluation (GRADE), RoB 2.0, ROBINS-I, Moderate to very low certainty evidence; serious risk of confounding bias in 5 of the 7 nonrandomized studies (N = 631)
- GRADE
- RoB 2.0
- ROBINS-I
- Moderate to very low certainty evidence; serious risk of confounding bias in 5 of the 7 nonrandomized studies (N = 631)
Pooled result
As reported in the abstract
Long-term postoperative pain scores · >3 months
- Comparable pain scores after RA and GA in 6 of the 7 studies using a pain score (4 RCTs, N = 273; 2 nonrandomized, N = 305)
Further pooled results
Opioid prescription filling, complex regional pain syndrome (CRPS) incidence, Mayo Wrist Score (MWS), Disability of the Arm, Shoulder and Hand (DASH) score
- Comparable long-term outcomes in 6 of the 7 studies using secondary outcomes
Pain and DASH scores (2 prospective observational studies, 279 patients)
- Statistically significant difference: less pain and better DASH scores after brachial plexus anesthesia
Original publication
A Systematic Review on Long-Term Postsurgical Pain Outcomes; What Is the Effect of Upper Extremity Regional Anesthesia? Anesth Analg. Published 14 July 2023. doi:10.
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