surgery on these outcomes. METHODS: A systematic search was conducted in MEDLINE, EMBASE, CENTRAL, and CINHAL for randomized controlled trials (from inception to April 2022) of adult patients undergoing elective noncardiac surgeries that evaluated any regional technique and included one of our primary outcomes: (1) prolonged opioid use after surgery (continued opioid use ≥2 months postsurgery) and (2) chronic postsurgical pain (pain ≥3 months postsurgery). We conducted a random-effects meta-analysis on the specified outcomes and used the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach to rate the quality of evidence. RESULTS: Thirty-seven studies were included in the review. Pooled estimates indicated that regional anesthesia had a significant effect on reducing prolonged opioid use (relative risk [RR] 0.48, 95% CI, 0.24–0.96, P = .04, I2 0%, 5 trials, n = 348 patients, GRADE low quality). Pooled estimates for chronic pain also indicated a significant effect favoring regional anesthesia at 3 (RR, 0.74, 95% CI, 0.59–0.93, P = .01, I2 77%, 15 trials, n = 1489 patients, GRADE moderate quality) and 6 months (RR, 0.72, 95% CI, 0.61–0.85, P < .001, I2 54%, 19 trials, n = 3457 patients, GRADE moderate quality) after surgery. No effect was found in the pooled analysis at 12 months postsurgery (RR, 0.44, 95% CI, 0.16–1.17, P = .10). CONCLUSIONS: The results of this study suggest that regional anesthesia potentially reduces chronic postsurgical pain up to 6 months after surgery. Our findings also suggest a potential decrease in the development of persistent opioid use....

中文翻译：

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围手术期区域麻醉对非心脏手术后持续使用阿片类药物和慢性疼痛的影响：随机对照试验的系统评价和荟萃分析


手术对这些结果。方法： 在 MEDLINE 、 EMBASE 、 CENTRAL 和 CINHAL 中对接受择期非心脏手术的成年患者的随机对照试验 （从建库到 2022 年 4 月） 进行了系统检索，这些试验评估了任何区域技术并包括我们的主要结局之一： （1） 术后阿片类药物使用时间延长 （术后持续使用阿片类药物 ≥ 2 个月） 和 （2） 慢性术后疼痛 （术后疼痛 ≥ 3 个月）。我们对特定结局进行了随机效应meta分析，并使用建议分级、评估、开发和评价（Grading of Recommendations， Assessment， Development， and Evaluations， GRADE）方法对证据质量进行评级。结果： 本综述纳入 37 项研究。汇总估计表明，区域麻醉对减少阿片类药物的长期使用有显着影响（相对风险 [RR] 0.48,95% CI，0.24-0.96，P = .04，I2 0%，5 项试验，n = 348 名患者，GRADE 低质量）。慢性疼痛的汇总估计还表明，术后 3 个月（RR，0.74,95% CI，0.59-0.93，P = .01，I2 77%，15 项试验，n = 1489 名患者，GRADE 中等质量）和 6 个月（RR，0.72,95% CI，0.61-0.85，P < .001，I2 54%，19 项试验，n = 3457 名患者，GRADE 中等质量）具有显著效果。术后 12 个月时，汇总分析未发现任何影响 （RR，0.44,95% CI，0.16-1.17，P = .10）。结论： 本研究的结果表明，区域麻醉有可能减轻术后长达 6 个月的慢性术后疼痛。我们的研究结果还表明，持续使用阿片类药物的发展可能会减少。