Cochrane · systematic review · CD007105
Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children
Weinstein, EJ, Levene, JL, Cohen, MS, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
10
current version
GRADE rated
5
No studies
5
Included studies
NR
No studies 5 · 50%Ungraded 0 · 0%Very low 0 · 0%Low 2 · 20%Moderate 3 · 30%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyThoracic epidural anaesthesia versus conventional pain control to prevent persistent pain after open thoracotomy
Population: people undergoing open thoracotomy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent pain 3 to 18 months after thoracotomy (We defined persistent postsurgical pain as new pain that did not exist before the operation, measured using differences in scores based on validated pain scales; patient interview between 3 to 18 m... Thoracic epidural anaesthesia vs conventional pain control | OR 0.52 [0.32, 0.84] | 7 studies · 499 participants | Moderate Downgraded: risk of bias, inconsistency |
Adverse effects of epidural anaesthesia ‐ not reported Thoracic epidural anaesthesia vs conventional pain control | no estimate extracted | NR | No studies |
Regional anaesthesia compared to conventional pain control for breast cancer surgery
Population: women with breast cancer undergoing elective surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent pain 3 to 12 months after breast cancer surgery (We defined persistent postsurgical pain as new pain that did not exist before the operation, measured using differences in scores based on validated pain scales; patient interview between... Regional anaesthesia vs conventional pain control | OR 0.43 [0.28, 0.68] | 18 studies · 1297 participants | Low Downgraded: risk of bias, inconsistency |
Adverse effects of paravertebral block for breast cancer surgery Regional anaesthesia vs conventional pain control | no estimate extracted | NR | No studies |
Local or regional anaesthesia for the prevention of chronic pain after caesarean section
Population: women after caesarean section
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent pain 3 to 8 months after caesarean section (We defined persistent postsurgical pain as new pain that did not exist before the operation, measured using differences in scores based on validated pain scales; patient interview between 3 to... | OR 0.46 [0.28, 0.78] | 4 studies · 551 participants | Moderate Downgraded: risk of bias |
Adverse effects of local or regional anaesthesia ‐ not reported | no estimate extracted | NR | No studies |
Continous donor site local anaesthetic infusion for the prevention of persistent postoperative pain after iliac crest bone graft harvesting
Population: people after iliac crest bone graft harvesting
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent pain 3 to 55 months after iliac crest bone graft harvesting (We defined persistent postsurgical pain as new pain that did not exist before the operation, measured using differences in scores based on validated pain scales; patient inter... | OR 0.2 [0.04, 1.09] | 3 studies · 123 participants | Low Downgraded: imprecision |
Adverse effects of continuous local anaesthetic infusion ‐ not reported | no estimate extracted | NR | No studies |
Continous intravenous local anaesthetic infusion for the prevention of persistent pain after breast cancer surgery
Population: women with breast cancer undergoing elective surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent pain 3 to 6 months after breast cancer surgery (We defined persistent postsurgical pain as new pain that did not exist before the operation, measured using differences in scores based on validated pain scales; patient interview between ... | OR 0.24 [0.08, 0.69] | 2 studies · 97 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse effects of continuous local anaesthetic infusion ‐ not reported | no estimate extracted | NR | No studies |
Thoracic epidural anaesthesia versus conventional pain control to prevent persistent pain after open thoracotomy
Population: people undergoing open thoracotomy
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent pain 3 to 18 months after thoracotomy (We defined persistent postsurgical pain as new pain that did not exist before the operation, measured using differences in scores based on validated pain scales; patient interview between 3 to 18 m... Thoracic epidural anaesthesia vs conventional pain control | OR 0.52 [0.32, 0.84] | 7 studies · 499 participants | Moderate Downgraded: risk of bias, inconsistency |
Adverse effects of epidural anaesthesia ‐ not reported Thoracic epidural anaesthesia vs conventional pain control | no estimate extracted | NR | No studies |
Regional anaesthesia compared to conventional pain control for breast cancer surgery
Population: women with breast cancer undergoing elective surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent pain 3 to 12 months after breast cancer surgery (We defined persistent postsurgical pain as new pain that did not exist before the operation, measured using differences in scores based on validated pain scales; patient interview between... Regional anaesthesia vs conventional pain control | OR 0.43 [0.28, 0.68] | 18 studies · 1297 participants | Low Downgraded: risk of bias, inconsistency |
Adverse effects of paravertebral block for breast cancer surgery Regional anaesthesia vs conventional pain control | no estimate extracted | NR | No studies |
Local or regional anaesthesia for the prevention of chronic pain after caesarean section
Population: women after caesarean section
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent pain 3 to 8 months after caesarean section (We defined persistent postsurgical pain as new pain that did not exist before the operation, measured using differences in scores based on validated pain scales; patient interview between 3 to... | OR 0.46 [0.28, 0.78] | 4 studies · 551 participants | Moderate Downgraded: risk of bias |
Adverse effects of local or regional anaesthesia ‐ not reported | no estimate extracted | NR | No studies |
Continous donor site local anaesthetic infusion for the prevention of persistent postoperative pain after iliac crest bone graft harvesting
Population: people after iliac crest bone graft harvesting
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent pain 3 to 55 months after iliac crest bone graft harvesting (We defined persistent postsurgical pain as new pain that did not exist before the operation, measured using differences in scores based on validated pain scales; patient inter... | OR 0.2 [0.04, 1.09] | 3 studies · 123 participants | Low Downgraded: imprecision |
Adverse effects of continuous local anaesthetic infusion ‐ not reported | no estimate extracted | NR | No studies |
Continous intravenous local anaesthetic infusion for the prevention of persistent pain after breast cancer surgery
Population: women with breast cancer undergoing elective surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent pain 3 to 6 months after breast cancer surgery (We defined persistent postsurgical pain as new pain that did not exist before the operation, measured using differences in scores based on validated pain scales; patient interview between ... | OR 0.24 [0.08, 0.69] | 2 studies · 97 participants | Moderate Downgraded: risk of bias, imprecision |
Adverse effects of continuous local anaesthetic infusion ‐ not reported | no estimate extracted | NR | No studies |
Should thoracic epidural anaesthesia versus conventional pain control be used to prevent persistent (chronic) pain after open thoracotomy
Population: open thoracotomy1
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent Pain Six Months after Thoracotomy telephone interview six months after surgery Should thoracic epidural anaesthesia vs conventional pain control be used | OR 0.34 [0.19, 0.6] | 3 studies · 250 participants | Moderate Downgraded: risk of bias, inconsistency |
Adverse Effects of Epidural Anaesthesia ‐ not reported Should thoracic epidural anaesthesia vs conventional pain control be used | no estimate extracted | NR | No studies |
Paravertebral block compared to conventional pain control for breast cancer surgery
Population: patients with breast cancer surgery
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Persistent Pain Six Months after Breast Cancer Surgery telephone interview six months after surgery Paravertebral block vs conventional pain control | OR 0.37 [0.14, 0.94] | 2 studies · 89 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Adverse effects of paravertebral block for breast cancer surgery Paravertebral block vs conventional pain control | no estimate extracted | 0 studies · 0 participants | Ungraded |