Evidence map›Paper›PMID 30174798›Full record

ArticleOncotarget2018

The efficacy and safety of first-line therapies for preventing chronic post-surgical pain: a network meta-analysis.

Jie Ning, Jing Luo, Zengdong Meng, Chong Luo, Gang Wan, Jie Liu, Sanrong Wang, Xingye Lian, N D Melgiri, Yang Sun and 1 more

Open access · diamondAbstract read
In one paragraph

Article in Oncotarget, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Jie NingDepartment of Pain Medicine, The First People's Hospital of Yunnan Province, Yunnan, Kunming, China.
Jing LuoDepartment of Pain Medicine, The First People's Hospital of Yunnan Province, Yunnan, Kunming, China.
Zengdong MengDepartment of Orthopedics, The First People's Hospital of Yunnan Province, Yunnan, Kunming, China.
Chong LuoDepartment of Orthopedics, The First People's Hospital of Yunnan Province, Yunnan, Kunming, China.
Gang WanDepartment of Orthopedics, The First People's Hospital of Yunnan Province, Yunnan, Kunming, China.
Jie LiuDepartment of Orthopedics, The First People's Hospital of Yunnan Province, Yunnan, Kunming, China.
Sanrong WangDepartment of Pain Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, Jiangbei, China.
Xingye LianDepartment of Orthopedics, The First People's Hospital of Yunnan Province, Yunnan, Kunming, China.
N D MelgiriImpactys Foundation for Biomedical Research, San Diego, CA, United States of America.
Yang SunInstitute of Ultrasound Imaging, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, Jiangbei, China.
Rongzhong HuangDepartment of Gerontology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, Jiangbei, China.
First People's Hospital of Yunnan Province · CNDalian Medical University · CNChongqing Medical University · CNFoundation for Biomedical Research · USSecond Affiliated Hospital of Chongqing Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDue to conflicting evidence regarding first-line therapies for chronic post-surgical pain (CPSP), here we comparatively evaluated the efficacy and safety of first-line therapies for the prevention of CPSP. MATERIALS AND

methodsMEDLINE, EMBASE, and Cochrane CENTRAL databases were searched for randomized, controlled trials (RCTs) of systemic drugs measuring pain three months or more post-surgery. Pairwise meta-analyses (a frequentist technique directly comparing each intervention against placebo) and network meta-analyses (a Bayesian technique simultaneously comparing several interventions via an evidence network) compared the mean differences for primary efficacy (reduction in all pain), secondary efficacy (reduction in moderate or severe pain), and primary safety (drop-out rate from treatment-related adverse effects). Ranking probabilities from the network meta-analysis were transformed using surface under the cumulative ranking analysis (SUCRA). Sensitivity analyses evaluated the impact of age, gender, surgery type, and outlier studies.

resultsTwenty-four RCTs were included. Mexiletine and ketamine ranked highest in primary efficacy, while ketamine and nefopam ranked highest in secondary efficacy. Simultaneous SUCRA-based rankings of the interventions according to both efficacy and safety revealed that nefopam and mexiletine ranked highest in preventing CPSP. Through the sensitivity analyses, gabapentin and ketamine remained the most-highly-ranked in terms of efficacy, while nefopam and ketamine remained the most-highly-ranked in terms of safety.

conclusionsNefopam and mexiletine may be considered as first-line therapies for the prevention of CPSP. On account of the paucity of evidence available on nefopam and mexiletine, gabapentin and ketamine may also be considered. Venlafaxine is not recommended for the prevention of CPSP.

Indexed as

chronic post-surgical painCPSPmexiletinenefopampregabalin

Identifiers

PMID30174798
PMCPMC6112831
OpenAlexW2769623215

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.