Efficacy and safety of multimodal analgesic techniques for preventing chronic postsurgery pain under different surgical categories: a meta-analysis

Abstract

The purpose of this meta-analysis was to compare the efficacy and safety of regional anesthesia to manage chronic postsurgery pain. A systematic search of PubMed, EmBase, and the Cochrane Central Register of Controlled Trials was performed to identify randomized controlled trials that focused on chronic pain frequency, analgesic consumption, and adverse effects under different surgical categories. We collected 21 trials assessing 1,980 patients for our meta-analysis. The summary of relative risks (RRs) and standard mean differences (SMDs) were calculated to measure the treatment effect of regional anesthesia. Results indicated that regional anesthesia significantly reduced the frequency of postsurgery pain (RR, 0.69; 95% confidence interval [CI], 0.56–0.85; p < 0.001). The results showed significant differences in overall patient satisfaction between applications with and without regional anesthesia (SMD, 1.95; 95%CI, 0.83–3.06; p = 0.001); however in other results, there were no significant differences between the two groups. Subgroup analysis suggested that regional anesthesia treatment might differ according to country. In conclusion, our study indicated that regional anesthesia was effective and safe in reducing the frequency of postsurgery pain and improved overall patient satisfaction; however, studies on the long-term efficacy and safety of regional anesthesia are still required to further confirm these findings.

The Practice of Multimodal Analgesia Technique for Patients Undergoing Surgery under General Anaesthesia in Debre Markos Compersive Specialized Hospital Debre Markos, East Gojjam, Ethiopia, 2022. A Cross-Sectional Study

“…Nationwide research in the United States of America showed tremendous variations in the utilization of multimodal therapy use not accounted for by patient or hospital characteristics and the mean probability of receiving multimodal analgesia as 90.4%. However, the presence of this practice in different hospitals of Ethiopia is not known yet making it difficult to compare the results of this research [9][10][11][12].…”

Systematic Reviews and Meta-analyses in Regional Anesthesia and Pain Medicine (Part II): Guidelines for Performing the Systematic Review

“…Example of asymmetrical and symmetrical funnel plots with author commentary. Funnel plots were generated by extracting data from Zhou et al 91 and Zenebe et al 92 The funnel plot is a scatter plot that displays the effect estimates from individual studies against a measure of each study size. As detailed in the graph, the horizontal axis represents some measure of effect estimate, while the vertical axis represents some measure of study size.…”

Mon patient prend des opioïdes avant la chirurgie : qu’est-ce que cela change ?

“…Son utilisation chez ces patients repose sur le bon sens clinique. Une littérature de plus en plus abondante semble confirmer que les techniques d'analgésie locorégionale préviendraient le développement des douleurs chroniques postopératoires [26]. Enfin, dans les populations «opioïdes dépendantes», le bénéfice de la kétamine a été évalué dans trois essais randomisés dans différents types de chirurgie (orthopédique, chirurgie du rachis et lithotripsie) [27][28][29] et son utilisation semble apporter un bénéfice important.…”