Quality of meta-analyses of non-opioid, pharmacological, perioperative interventions for chronic postsurgical pain: a systematic review.

Autor:	McGregor RH; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada., Warner FM; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada.; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada., Linde LD; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada.; Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada., Cragg JJ; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada.; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada., Osborn JA; Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.; Department of Anesthesia, Providence Healthcare, Vancouver, British Columbia, Canada., Varshney VP; Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.; Department of Anesthesia, Providence Healthcare, Vancouver, British Columbia, Canada., Schwarz SKW; Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada., Kramer JLK; International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada kramer@icord.org.; Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.
Jazyk:	angličtina
Zdroj:	Regional anesthesia and pain medicine [Reg Anesth Pain Med] 2022 Apr; Vol. 47 (4), pp. 263-269. Date of Electronic Publication: 2022 Jan 13.
DOI:	10.1136/rapm-2021-102981
Abstrakt:	Background: In an attempt to aggregate observations from clinical trials, several meta-analyses have been published examining the effectiveness of systemic, non-opioid, pharmacological interventions to reduce the incidence of chronic postsurgical pain. Objective: To inform the design and reporting of future studies, the purpose of our study was to examine the quality of these meta-analyses. Evidence Review: We conducted an electronic literature search in Embase, MEDLINE, and the Cochrane Database of Systematic Reviews. Published meta-analyses, from the years 2010 to 2020, examining the effect of perioperative, systemic, non-opioid pharmacological treatments on the incidence of chronic postsurgical pain in adult patients were identified. Data extraction focused on methodological details. Meta-analysis quality was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) critical appraisal tool. Findings: Our search yielded 17 published studies conducting 58 meta-analyses for gabapentinoids (gabapentin and pregabalin), ketamine, lidocaine, non-steroidal anti-inflammatory drugs, and mexiletine. According to AMSTAR 2, 88.2% of studies (or 15/17) were low or critically low in quality. The most common critical element missing was an analysis of publication bias. Trends indicated an improvement in quality over time and association with journal impact factor. Conclusions: With few individual trials adequately powered to detect treatment effects, meta-analyses play a crucial role in informing the perioperative management of chronic postsurgical pain. In light of this inherent value and despite a number of attempts, high-quality meta-analyses are still needed. Prospero Registration Number: CRD42021230941. Competing Interests: Competing interests: None declared. (© American Society of Regional Anesthesia & Pain Medicine 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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