European journal of pain
Postoperative Pain Treatment After Pancreatic Surgery: A Systematic Review With Meta-Analyses and Trial Sequential Analyses
By Lassen CD, Yousef F, Aasvang EK and 3 others.
Abstract
Background
Major pancreatic surgery is associated with significant postoperative pain that impairs early mobilisation and recovery. ERAS guidelines for pancreaticoduodenectomy recommend multimodal opioid-sparing analgesia, with a strong recommendation for epidural analgesia and continuous wound infiltration as an alternative. Other techniques may be beneficial, but their efficacy and safety remain uncertain.
Objective
To investigate the efficacy and adverse events of different postoperative analgesic modalities for patients undergoing total pancreatectomy, pancreaticoduodenectomy and distal pancreatectomy. Databases and data treatment: This PROSPERO-registered systematic review (ID CRD420251085003) reported in accordance with the PRISMA guidelines. A search for randomised controlled trials was conducted in Medline, Cochrane Central Register of Controlled Trials and Embase. Meta-analyses were performed in Review Manger, risk of bias was assessed with RoB 2, trial sequential analyses were performed, and the certainty of evidence was evaluated using GRADE.