Perioperative Regional Anesthesia on Persistent Opioid Use and Chronic Pain after Noncardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors' conclusion
The results of this study suggest that regional anesthesia potentially reduces chronic postsurgical pain up to 6 months after surgery.
Study context
- Population
- Adults undergoing elective noncardiac surgery37 studies
- Comparison
- Perioperative RA vs no RA
- Outcome
- (1) Prolonged opioid use (continued opioid use ≥2 months postsurgery) and (2) chronic postsurgical pain (pain ≥3 months postsurgery)
Methodological detailsrandom-effects meta-analysis, Grading of Recommendations, Assessment, Development, and Evaluations (GRADE)
- Random-effects meta-analysis
- GRADE
Pooled result
As reported in the abstract
Regional anesthesia vs ControlRelative risk (95% CI)P value
Prolonged opioid use; I 2 0%, 5 trials, n = 348, GRADE low quality
0.48(0.24–0.96)
P = 0.04Chronic pain at 3 months; I 2 77%, 15 trials, n = 1489, GRADE moderate quality
0.74(0.59–0.93)
P = 0.01Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Chronic postsurgical pain · up to 6 months19 trials, n = 3457 · GRADE moderate quality | 0.72 (0.61–0.85) | P < 0.001 | |
| 0.512Relative risk (log scale) |
- Chronic postsurgical pain: I 2 54%
Chronic postsurgical pain · 12 months
- No effect in the pooled analysis at 12 months postsurgery, RR
- 0.44
- 95% CI
- 0.16-1.17
- P
- P = 0.10
Original publication
Perioperative Regional Anesthesia on Persistent Opioid Use and Chronic Pain after Noncardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Anesth Analg. Published 4 September 2024. doi:10.
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