Can Preoperative Intravenous Corticosteroids Administration Reduce Postoperative Pain Scores Following Spinal Fusion?: A Meta-Analysis

Hua-rong, WU; Wang, Huiwang; Liu, Yang; Wu, Zhanyong

doi:10.1080/08941939.2018.1505983

Cited by 2 publications

(1 citation statement)

References 34 publications

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“…Several systematic reviews have explored the effectiveness of treatments for the prevention of CPSP including psychotherapy [11], gabapentinoids [12,13], antidepressants [14], ketamine [15], opioids [16], nonsteroidal anti-inflammatory drugs (NSAIDs) [17], muscle relaxants [18], acetaminophen [19], and corticosteroids [17,20]. Most existing trials focus on treatment effects of interventions relative to placebo or usual care; however, comparisons between active therapies are more important when deciding between several competing interventions [21].…”

Section: Introductionmentioning

confidence: 99%

Comparative benefits and harms of perioperative interventions to prevent chronic pain after orthopedic surgery: a systematic review and network meta-analysis of randomized trials

Al-Asadi,

Torabiardakani,

Darzi

et al. 2024

Syst Rev

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Background Chronic postsurgical pain (CPSP) is common following musculoskeletal and orthopedic surgeries and is associated with impairment and reduced quality of life. Several interventions have been proposed to reduce CPSP; however, there remains uncertainty regarding which, if any, are most effective. We will perform a systematic review and network meta-analysis of randomised trials to assess the comparative benefits and harms of perioperative pharmacological and psychological interventions directed at preventing chronic pain after musculoskeletal and orthopedic surgeries. Methods We will search MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Central Register of Controlled Trials from inception to present, without language restrictions. We will include randomised controlled trials that as follows: (1) enrolled adult patients undergoing musculoskeletal or orthopedic surgeries; (2) randomized them to any pharmacological or psychological interventions, or their combination directed at reducing CPSP, placebo, or usual care; and (3) assessed pain at 3 months or more after surgery. Screening for eligible trials, data extraction, and risk-of-bias assessment using revised Cochrane risk-of-bias tool (RoB 2.0) will be performed in duplicate and independently. Our main outcome of interest will be the proportion of surgical patients reporting any pain at ≥ 3 months after surgery. We will also collect data on other patient important outcomes, including pain severity, physical functioning, emotional functioning, dropout rate due to treatment-related adverse event, and overall dropout rate. We will perform a frequentist random-effects network meta-analysis to determine the relative treatment effects. When possible, the modifying effect of sex, surgery type and duration, anesthesia type, and veteran status on the effectiveness of interventions will be investigated using network meta-regression. We will use the GRADE approach to assess the certainty evidence and categorize interventions from most to least beneficial using GRADE minimally contextualised approach. Discussion This network meta-analysis will assess the comparative effectiveness of pharmacological and psychological interventions directed at preventing CPSP after orthopedic surgery. Our findings will inform clinical decision-making and identify promising interventions for future research. Systematic review registration PROSPERO CRD42023432503.

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