Pharmacotherapy for the Prevention of Chronic Pain after Surgery in Adults: An Updated Systematic Review and Meta-analysis
نویسندگان
چکیده
Background Chronic postsurgical pain can severely impair patient health and quality of life. This systematic review update evaluated the effectiveness systemic drugs to prevent chronic pain. Methods The authors included double-blind, placebo-controlled, randomized controlled trials including adults that perioperative drugs. Studies same drug(s) administered similarly were pooled. primary outcome was proportion reporting any at 3 or more months postsurgery. Results identified 70 new studies 40 from 2013. Most ketamine, pregabalin, gabapentin, IV lidocaine, nonsteroidal anti-inflammatory drugs, corticosteroids. Some meta-analyses showed statistically significant—but unclear clinical relevance—reductions in prevalence after treatment with Meta-analyses than three 500 participants no effect ketamine on 6 when for 24 h less (risk ratio, 0.62 [95% CI, 0.36 1.07]; prevalence, 0 88% ketamine; 94% placebo) 0.91 0.74 1.12]; 71% 5 78% placebo), pregabalin 0.88 0.70 1.10]; 4 pregabalin; 80% 0.78 0.47 1.28]; 68% 69% h, an moderate/severe 0.33 0.68]; 20% 34% placebo). However, results should be interpreted caution given small study sizes, variable surgical types, dosages, timing method measurements relation acute trajectory question, preoperative status. Conclusions Despite agreement is important topic, extremely little progress has been made since 2013, likely due designs being insufficient address complexities this multifactorial problem. Editor’s Perspective What We Already Know about Topic Article Tells Us That Is New
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ژورنال
عنوان ژورنال: Anesthesiology
سال: 2021
ISSN: ['0003-3022', '1528-1175']
DOI: https://doi.org/10.1097/aln.0000000000003837