SynthesisJournal of clinical anesthesia2019
Local anesthetics and regional anesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children: A Cochrane systematic review and meta-analysis update.
Synthesis in Journal of clinical anesthesia, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled 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.
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.
Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Erector spinae plane block in pediatric surgery: a systematic review and meta-analysis.BMC anesthesiology · 2026Pooled it
- A systematic review and network meta-analysis of pharmaceutical interventions used to manage chronic pain.Scientific reports · 2024Pooled it
- Postoperative analgesic effectiveness of quadratus lumborum block: systematic review and meta-analysis for adult patients undergoing hip surgery.Journal of orthopaedic surgery and research · 2022Pooled it
- Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children.The Cochrane database of systematic reviews · 2018Pooled it
- Ultrasound-Guided Quadratus Lumborum Block Enhances the Quality of Recovery after Gastrointestinal Surgery: A Randomized Controlled Trial.Pain research & management · 2022Trial
- Application of XGBoost in the prediction of acute postoperative pain after major noncardiac surgery in older patients.Molecular painTrial
- Fascial plane blocks in pediatric patients.Journal of anesthesia, analgesia and critical care · 2026Review
- Hydrogel Drug Delivery Systems and Liposomal Bupivacaine: Innovations and Future Perspectives in Pain Management.Journal of clinical medicine · 2025Review
- Factors associated with postoperative rebound pain after peripheral nerve block anaesthesia for orthopedic trauma surgery: a retrospective cohort analysis.Journal of orthopaedic surgery and research · 2025Article
- Chronic postsurgical pain and transitional pain services: a narrative review highlighting European perspectives.Regional anesthesia and pain medicine · 2025Review
- Optimizing accrual to a large-scale, clinically integrated randomized trial in anesthesiology: A 2-year analysis of recruitment.Clinical trials (London, England) · 2025Article
- Chronic postoperative inguinal pain (CPIP) after pediatric inguinal hernia repair-a retrospective analysis.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Predictive Factors of Acute Pain After Day Surgery: A Meta-Analysis.Journal of pain research · 2025Review
- Comparative study of lidocaine- saline versus saline as washout for lumpectomy cavity on acute postoperative pain.Heliyon · 2024Article
- Chronic Postsurgical Pain Following Lung Transplantation: Characteristics, Risk Factors, Treatment, and Prevention: A Narrative Review.Pain and therapy · 2024Review
- Analgesic Effect of Caudal and Abdominal Nerve Blocks among Children Undergoing Inguinal Surgeries: An Original Research.Journal of pharmacy & bioallied sciences · 2024Article
- Severe Postoperative Pain in Total Knee Arthroplasty Patients: Risk Factors, Insights and Implications for Pain Management via a Digital Health Approach.Journal of clinical medicine · 2023Article
- Evidence-based guideline on chronic postsurgical pain management in adult patients in resource-restricted setting, 2023: systematic review and guideline.Annals of medicine and surgery (2012) · 2023Article
- Practical strategies for the prevention and management of chronic postsurgical pain.The Korean journal of pain · 2023Review
- Incidence of Chronic Postsurgical Pain after Upper Extremity Surgery and its Correlation with Preoperative Pain.Plastic and reconstructive surgery. Global open · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundRegional anesthesia may mitigate the risk of persistent postoperative pain (PPP). This Cochrane review, published originally in 2012, was updated in 2017.
methodsWe updated our search of Cochrane CENTRAL, PubMed, EMBASE and CINAHL to December 2017. Only RCTs investigating local anesthetics (by any route) or regional anesthesia versus any combination of systemic (opioid or non-opioid) analgesia in adults or children, reporting any pain outcomes beyond three months were included. Data were extracted independently by at least two authors, who also appraised methodological quality with Cochrane 'Risk of bias' assessment and pooled data in surgical subgroups. We pooled studies across different follow-up intervals. As summary statistic, we reported the odds ratio (OR) with 95% confidence intervals and calculated the number needed to benefit (NNTB). We considered classical, Bayesian alternatives to our evidence synthesis. We explored heterogeneity and methodological bias.
results40 new and seven ongoing studies, identified in this update, brought the total included RCTs to 63. We were only able to synthesize data from 39 studies enrolling 3027 participants in a balanced design. Evidence synthesis favored regional anesthesia for thoracotomy (OR 0.52 [0.32 to 0.84], moderate-quality evidence), breast cancer surgery (OR 0.43 [0.28 to 0.68], low-quality evidence), and cesarean section (OR 0.46, [0.28 to 0.78], moderate-quality evidence). Evidence synthesis favored continuous infusion of local anesthetic after breast cancer surgery (OR 0.24 [0.08 to 0.69], moderate-quality evidence), but was inconclusive after iliac crest bone graft harvesting (OR 0.20, [0.04 to 1.09], low-quality evidence).
conclusionsRegional anesthesia reduces the risk of PPP. Small study size, performance, null, and attrition bias considerably weakened our conclusions. We cannot extrapolate to other interventions or to children.
Indexed as
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What OpenQuestion holds
Registered trials
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.