SynthesisThe Cochrane database of systematic reviews2025
Regional analgesia techniques for postoperative pain after breast cancer surgery: a network meta-analysis.
Synthesis in The Cochrane database of systematic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis 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
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Regional analgesia techniques for postoperative pain after breast cancer surgery: a network meta-analysis.The Cochrane database of systematic reviews · 2025Pooled it
- Rhomboid intercostal block versus erector spinae plane block for perioperative analgesia in patients undergoing reduction mammoplasty: a prospective randomized study.BMC anesthesiology · 2026Trial
- Lidocaine-Based vs Sufentanil-Based PCIA After Pulmonary Resection Surgery: A Randomized Controlled Trial.Drug design, development and therapy · 2025Trial
- Fascial Plane Blocks in Perioperative and Pain Medicine: From Mechanisms to Emerging Multitarget Interfascial Strategies.Current pain and headache reports · 2026Review
- Erector spinae plane block.BJA education · 2026Review
- Opioid-sparing and opioid-free anaesthesia: concepts, rationale, evidence, and practical implications.Anaesthesiology intensive therapy · 2026Review
- Targeted intrapleural analgesia through an integrated chest tube after thoracoscopic lung resection: a randomized controlled trial.Journal of thoracic disease · 2026Article
- Evaluating a Novel Regional Technique: Serratus Posterior Superior Intercostal Plane Block Reduces Opioid Consumption and Pain Scores after Breast-conserving Surgery: A Randomized Controlled Trial.Turkish journal of anaesthesiology and reanimation · 2026Article
- [Peripheral regional anesthesia and analgesia: "the magnificent seven" for training].Die Anaesthesiologie · 2026Review
- Intertransverse Process Block versus Erector Spinae Plane Block as Adjuncts to an Interpectoral Block for Breast Cancer Surgery: A Randomized Controlled Trial.Journal of pain research · 2026Article
- Serratus Posterior Superior Intercostal Plane Block and Serratus Anterior Plane Block Compared with Conventional Analgesia for Postoperative Analgesia in Breast Cancer Surgery: A Randomized Controlled Trial.Journal of pain research · 2026Article
- Thoracic wall fascial plane blocks: a narrative review for breast, thoracic, and cardiac surgery.Journal of anesthesia, analgesia and critical care · 2025Review
- Analgesic Efficacy of Acetaminophen/Ibuprofen as an Adjuvant in Patient-Controlled Analgesia for Postoperative Pain After Oncoplastic Breast Surgery: A Randomized Controlled Trial.Journal of clinical medicine · 2025Article
- Conformational and Intermolecular Interaction Analysis of Tiaprofenic Acid: A X-Ray Powder Diffraction and First Principle Modeling Analysis.Molecules (Basel, Switzerland) · 2025Article
- Review
- Improving the Patient Experience in Breast Reconstruction: ERAS and Beyond.Journal of clinical medicine · 2025Review
- Erector spinae plane block vs. paravertebral block for postoperative analgesia in breast surgery: a meta-analysis of randomized trials.Brazilian journal of anesthesiology (Elsevier)Article
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.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationalePostoperative pain is an important outcome for individuals undergoing breast cancer surgery. Regional analgesia techniques are considered integral to postoperative pain management, but are not without risks.
objectivesTo assess the analgesic benefits and harms of different regional analgesia techniques in women undergoing breast cancer surgery. SEARCH
methodsWe searched CENTRAL, MEDLINE, Embase, CINAHL, Scopus, and Web of Science from inception to 6 June 2023 without restrictions on language, publication year, or publication status. ELIGIBILITY CRITERIA: We included randomised controlled trials (RCTs) comparing two or three of the following regional analgesia techniques in women undergoing breast cancer surgery: paravertebral block (PVB), erector spinae plane block (ESPB), pectoral nerve block (PEC), and serratus anterior plane block (SAPB). OUTCOMES: Our critical outcomes were postoperative pain (rated on a visual analogue scale (VAS) or numeric rating scale (NRS) of 0-10) and rates of regional analgesia-related complications. Our important outcomes were quality of recovery, time to first analgesic request, postoperative opioid and nonsteroidal anti-inflammatory drug (NSAID) use, and postoperative nausea and vomiting (PONV). RISK OF BIAS: We used the Cochrane risk of bias tool (RoB 2) to assess risk of bias. SYNTHESIS
methodsWe conducted network meta-analyses (NMAs) using multivariate frequentist random-effects models to calculate mean differences (MDs), standardised mean differences (SMDs), or risk ratios (RRs), each with its 95% confidence interval (CI). We used CINeMA to rate the certainty of evidence. We only included studies with an overall low risk of bias in the primary analysis. For postoperative pain, we considered one point difference as the minimal clinically important difference (MCID). INCLUDED STUDIES: We included 39 RCTs with a total of 2348 participants. The studies were conducted between 2013 and 2023 in Egypt, India, Turkey, China, Japan, USA, and Thailand. Most used single-shot long-acting anaesthetics administered with ultrasound guidance. In 35 studies, the surgery was modified radical mastectomy. All studies performed surgery under general anaesthesia in the hospital. Our primary analysis for postoperative pain included 16 studies. SYNTHESIS OF
resultsCritical outcomes Postoperative pain at rest at two hours This NMA included seven studies (384 participants). PEC is slightly more effective than PVB in reducing postoperative pain at rest at two hours (MD -0.47, 95% CI -0.73 to -0.22; P < 0.001, I AUTHORS'
conclusionsOverall, the regional analgesia techniques included in our NMAs seem comparable in reducing postoperative pain and rates of complications.
fundingThis Cochrane review had no dedicated funding. REGISTRATION: Protocol (2022): doi.org/10.1002/14651858.CD014818.
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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.