Epidural Analgesia Versus Systemic Opioids for Postoperative Pain Management After Video-Assisted Thoracic Surgery (VATS): A Systematic Review and Meta‐Analysis
Authors' conclusion
Epidural analgesia offers a small but possibly subclinical reduction in acute postoperative pain after VATS compared with systemic opioids, particularly when combined with baseline multimodal analgesia.
Study context
- Population
- Adults undergoing VATS receiving epidural analgesia or systemic opioids for postoperative pain
- Participants
- 946 adults · 4 randomized controlled trials (RCTs) · 4 observational studies
- Comparison
- Epidural analgesia vs systemic opioids
- Outcome
- Postoperative pain at rest and during activity (NRS/VAS)
- Follow-up
- POD1, POD2, and POD3
Pooled result
As reported in the abstract
Pain (NRS/VAS points), RCTs · POD 1 to 3
Pooled MD (pain reduction), at rest
0.8 NRS/VAS points
95% CI 0.2–1.3
I2 99%
Pooled MD (pain reduction), during activity
1.1 NRS/VAS points
95% CI 0.7–1.5
I2 98%
Further pooled results
Rescue-opioid use
- Lower with epidurals in three of four trials
Hospital LOS
- No consistent differences
Safety
Adverse effects
- No consistent differences
Original publication
Epidural Analgesia Versus Systemic Opioids for Postoperative Pain Management After VATS: A Systematic Review and Meta‐Analysis. Acta Anaesthesiol Scand. Published 12 September 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →