Regional anaesthesia and chronic postsurgical pain: a systematic review and network meta-analysis
Pooled result · Incidence of CPSPResult — go to the resultRelative risk 0.73 95% CI 0.67–0.80Authors' conclusion
Our findings indicate that regional anaesthesia reduces the incidence of CPSP for up to 12 months after surgery. The effectiveness of regional anaesthesia was influenced by the type of regional technique used, whereas the type of surgery, sex, or baseline risk did not have a significant impact.
Study context
- Population
- Patients undergoing surgery, in RCTs assessing regional anaesthesia for reduction of chronic postsurgical pain (CPSP)
- Participants
- 18,794 patients · 158 RCTs
- Comparison
- Regional anaesthesia vs no block
- Outcome
- Incidence of CPSP (pain persisting beyond 3 months after surgery)
Methodological detailsPRISMA-compliant, pairwise meta-analysis, meta-regression, Grading of Recommendations Assessment, Development and Evaluation (GRADE)/Confidence In Network Meta-Analysis (CINeMA) certainty assessment
- PRISMA-compliant
- Pairwise meta-analysis
- Meta-regression
- GRADE/CINeMA certainty assessment
Pooled result
Incidence of CPSP
Relative risk
0.73
95% CI 0.67–0.80
Regional anaesthesia vs No block
RR 0.73 (95% CI 0.67–0.80)
As reported in the abstract
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| CPSP after thoracotomy, network meta-analysis (subgroup)Neuraxial vs No block · low to very low certainty | 0.64 (0.49–0.83) | |
| CPSP after thoracotomy, network meta-analysis (subgroup)Peripheral vs No block · low to very low certainty | 0.84 (0.73–0.96) | |
| CPSP after video-assisted thoracoscopic surgery, network meta-analysis (subgroup)Neuraxial vs No block · low to very low certainty | 0.60 (0.45–0.80) | |
| CPSP after video-assisted thoracoscopic surgery, network meta-analysis (subgroup)Peripheral vs No block · low to very low certainty | 0.77 (0.63–0.94) | |
| 0.512Relative risk (log scale) |
CPSP by surgery type (subgroup)
- Mastectomy, RR
- 0.69 (95% CI 0.59-0.79)
- Thoracotomy, RR
- 0.72 (95% CI 0.55-0.96)
- Video-assisted thoracoscopic surgery, RR
- 0.73 (95% CI 0.56-0.96)
- Knee arthroplasty, RR
- 0.71 (95% CI 0.52-0.97)
- Reductions in CPSP within specific surgery types
Long-term opioid use
- Not statistically significantly different between groups, RR
- 0.88 (95% CI 0.61-1.28)
- Very low certainty
Meta-regression: surgery type, sex, baseline risk
- No significant effect of surgery type, sex or baseline risk
Original publication
Regional anaesthesia and chronic postsurgical pain: a systematic review and network meta-analysis. Br J Anaesth. Published 9 July 2026. doi:10.
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