Efficacy of vitamin C supplementation in preventing and treating complex regional pain syndrome type I (CRPS-I) in Orthopedic patients: A systematic review and meta-analysis

Abstract

Aim

Complex regional pain syndrome type I (CRPS-I) is a specific type of persistent pain which is often caused by fracture and surgery. There is no effective curative therapy available. However some studies have indicated that Vitamin C (VC) can reduce the incidence of CRPS-I. This study's objective is to investigate the effectiveness VC in preventing and treating CRPS-I.

Design

An Systematic review and Meta-analysis was done.

Data sources

Primary research studies from PubMed, Scopus, Web of Science, ProQuest, Embase database, and Cochran Library, and Google Scholar were reviewed. This search was conducted until March 27, 2024. This study was conducted without any language, place, and time restrictions. Study results were meta-analyzed with using effect sizes. To evaluate heterogeneity, we employed the Cochrane Q test and the I2 index.

Results

In our systematic review, 3947 articles were initially identified, with 3939 excluded for not meeting inclusion criteria, resulting in 8 studies being critically evaluated using Cochran's risk of bias checklist. The meta-analysis revealed that VC supplementation have effect on reducing CRPS-I post-limb surgery but this result shows that the pooled effect size is not statistically significant. The heterogeneity of the studies was low (I² = 26.28%, p = 0.22). Publication bias was detected, indicating asymmetry in the funnel plot.

Conclusion

The results of our study showed the positive effect of VC supplementation in reducing the prevalence of CRPS-I after limb surgery.