Perioperative interventions for the reduction of chronic postsurgical pain

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In this issue of PAIN, Martinez and co-workers publish a systemic review with a meta-analysis of randomized trials on the effect of perioperative pregabalin for the prevention of chronic postsurgical pain (CPSP).12 The primary outcome was CPSP after 3 months. Secondary outcomes included CPSP after 6 and 12 months and CPSP with a neuropathic pain component (CPSPNP) after 3, 6, and 12 months. The review comprises 18 studies, of which only 15 studies presented data on the primary outcome. Nine of the 15 studies, accounting for 1492 out of 1884 patients (79%), were unpublished and mainly identified through registry searches and personal communication with the authors. Martinez et al. conclude that there is no evidence to support the use of perioperative pregabalin for the reduction of CPSP. The quality of evidence for reduction of CPSPNP was too low to make any recommendations.
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