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Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery


Andreae, M.H. and Andreae, D.A.

Subject Keywords: Local anaesthetics, Regional anaesthesia, Conventional analgesia, Prevention, Persistent pain, Surgery
Topic: Chronic Conditions
Chronic Conditions
Type: Article
Region: International (other)

Chronic pain that persists long after surgery is frequent. About 10% of mothers complain about chronic pain after caesarean section. After surgery of the lung up to half of the people may continue to experience chronic pain more than six months after surgery. Local anaesthetics (numbing medicine) injected close to the nerves around the time of surgery may reduce the risk of developing chronic pain. This is called local or regional anaesthesia.

We searched the databases (CENTRAL, PubMed, EMBASE and CINAHL) to April 2012. We found 23 randomized controlled trials comparing the use of local or regional anaesthesia after various surgical interventions with conventional pain control regimens. The latter used opioids (like morphine) or non-opioid pain killers (like paracetamol (acetaminophen) or ibuprofen). We presented data from a total of 1090 people with outcomes at five to six months and 441 people with outcomes at 12 months. We pooled the data of 250 people after thoracotomy (lung surgery) and data of 89 people after breast cancer surgery, with outcomes at six months.

The pooled results show that the use of epidural anaesthesia after thoracotomy and paravertebral block after breast cancer surgery may reduce the risk of chronic pain six months after surgery in about one person out of every four to five people treated. The included studies were not however considered to be of high calibre and included only few people. We need more clinical trials to confirm this effect and to test regional anaesthesia for chronic pain after other surgeries.



Rights: © The Cochrane Collaboration
Suggested citation:

Andreae, M.H. and Andreae, D.A.. (2012) Local anaesthetics and regional anaesthesia for preventing chronic pain after surgery [Online]. Available from: [Accessed: 14th November 2019].


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