Regional anesthetics versus analgesia for stopping the persistent postsurgical pain: A meta‐analysis

Abstract

Regional anesthesia might moderate the risk of persistent postsurgical pain, but its effect compared to systemic analgesia is still conflicting. This meta-analysis study was performed to assess the relationship between the efficiency of regional anesthesia versus systemic analgesia in reducing pain persisting longer than 3months after surgery. Through a systematic literature search up to August 2020, 31 studies included 2975 subjects who underwent surgery at baseline and reported a total of 1471 subjects using regional anesthesia and 1319 subjects using conventional anesthesia were found recording relationships between efficiency of regional anesthesia versus systemic analgesia in reducing pain persisting longer than 3months after surgery. Odds ratio (OR) with 95% confidence intervals (CIs) was calculated between regional anesthesia versus systemic analgesia in reducing pain persisting longer than 3months after surgery using the dichotomous methods with a random or fixed-effect model. Number of subjects reporting persistent pain 3months postsurgery was significantly lower in regional anesthesia compared to systemic analgesia in thoracotomy (OR, 0.44; 95% CI, 0.29-0.65, P<.001); breast surgery (OR, 0.46; 95% CI, 0.29-0.72, P<.001); and cesarean section (OR, 0.44; 95% CI, 0.27-0.72, P<.001). Regional anesthesia might have an independent relationship with lower pain persisting longer than 3months after thoracotomy, breast surgery, and cesarean section. Further studies are required to validate these findings.