Clinical Journal of Pain最新文献

{"title":"The Validation of the Patients Endorsement of the Biopsychosocial Model of Chronic Pain (PEB) Scale in Young Adults with Chronic Pain.","authors":"Mathias Sanyer, Eric L Garland, Antonia Barke, Maria Kleinstäuber","doi":"10.1097/AJP.0000000000001395","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001395","url":null,"abstract":"<p><strong>Objectives: </strong>To validate the Patients Endorsement of the Biopsychosocial Model of Chronic Pain (PEB) Scale in young adults with chronic pain, assessing psychometric properties and associations with pain beliefs and readiness for pain self-management.</p><p><strong>Methods: </strong>A cross-sectional survey was administered to 240 young adults with chronic pain (≥3 months) via Prolific. Participants completed the PEB Scale and measures assessing readiness for pain self-management, pain beliefs, psychological variables, and pain characteristics. Reliability, factor structure, convergent/discriminant validity, and incremental validity were all assessed.</p><p><strong>Results: </strong>In the sample, the PEB Scale had a good internal consistency (Cronbach's α=.88). Factor analysis confirmed an unifactorial structure. Convergent validity was supported through a moderate correlation between the PEB Scale and readiness for pain self-management (PSOCQ Contemplation subscale, r=.32, P=.001). The scale also showed small-moderate correlations with pain interference (r=.25, P=.001) and psychological measures. Hierarchical regression analyses revealed the PEB Scale was associated with an increased chance to be in the contemplation phase (=.042, P<.001) or action/maintenance phase (=.021, P<.05) of pain self-management, when controlling for demographics, pain characteristics, beliefs, and psychological factors.</p><p><strong>Discussion: </strong>Higher PEB scores were associated with greater contemplation of and engagement in the self-management of chronic pain. The scale appears to be conceptually different from existing pain belief and psychological measures. Limitations include the use of self-report measures, limited effect sizes and demographic homogeneity of our sample. Future studies should test the scale in diverse groups, explore its sensitivity to change, and clinical utility.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operant Approach Activity Pacing Interventions for the Management of Chronic Pain: A Systematic Review.","authors":"Deborah Antcliff, Laura Burns, Eleanor English, Rosa MacKenzie, Adam W A Geraghty, Janiece Marriott-Smith, Rebecca Stansfield, Karen Storms, Clare Jinks, Melanie A Holden","doi":"10.1097/AJP.0000000000001393","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001393","url":null,"abstract":"<p><strong>Objectives: </strong>Operant approach activity pacing (undertaking activities according to quotas, e.g. amount/time/goal rather than according to symptom severity) is advised for chronic pain. There is no standardised intervention that addresses all the components of operant approach activity pacing. This systematic review aimed to identify operant approach activity pacing interventions for chronic pain and explore their components, effectiveness, feasibility and acceptability.</p><p><strong>Methods: </strong>Eligible studies included any type of evaluation (e.g. randomised controlled trials, feasibility/pilot, qualitative) among adults with chronic pain. Ineligible studies included interventions based on energy conservation/envelope theory/adaptive pacing therapy/symptom-contingency, and non-English language. Databases included: MEDLINE, Embase, CINAHL, AMED, PsycINFO, Cochrane CENTRAL, PEDro, OTseeker and Web of Science (from database inception to 26th March 2025). Two independent reviewers extracted data, including descriptions of interventions (TIDieR checklist), appraised risk of bias (Joanna Briggs Institute checklists) and evaluated confidence in the research (GRADE). Findings were synthesised narratively.</p><p><strong>Results: </strong>Nine studies (10 interventions; 11 papers) were included (873 participants). Interventions were heterogeneous in content, length (2-11 sessions) and tailored/untailored to participants' baseline behaviours. Common intervention components were pre-planning, activity-rest cycling/using rests and alternating activities/positions. Direction of effect (vote counting) was towards improved function, but mixed findings for pain/fatigue.</p><p><strong>Discussion: </strong>Studies showed mixed findings across outcomes, syntheses were limited to vote counting, with very low confidence in the evidence; limiting conclusions about effectiveness. The multiple components of activity pacing can be considered to further develop and test the effectiveness of operant activity pacing for chronic pain. Funder: NIHR School for Primary Care Research. (PROSPERO:CRD42023451469).</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Oblique Intercostal Plane Block for Postoperative Analgesia in Thoracoabdominal Procedures: A Systematic Review and meta-analysis.","authors":"Elias Batista da Silva Neto, João Paulo Aureliano de Carvalho, Matheus Rocha Peregrino, Pablo de Souza Ferreira, Liana Maria Tôrres de Araújo Azi, Rodrigo Leal Alves","doi":"10.1097/AJP.0000000000001392","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001392","url":null,"abstract":"<p><strong>Objectives: </strong>The primary objective was to analyze the efficacy of EOIPB in reducing use of opioids in postoperative period. Time and need for rescue analgesia, postoperative pain scores and incidence of nausea and vomiting were also evaluated.</p><p><strong>Methods: </strong>The review followed the PRISMA guidelines and was registered on PROSPERO (CRD42024622945). Randomized clinical trials that included adults undergoing thoracoabdominal surgery, comparing EOIPB with general anesthesia, multimodal anesthesia, or other regional blocks, were selected. Search was performed on May 2025 in PubMed, Embase, Scopus, and Cochrane Library databases, with no time or language restrictions. Certainty of the evidence was assessed using GRADE system.</p><p><strong>Results: </strong>Fifteen studies involving 899 patients were identified. Results indicated that EOIPB significantly reduced opioid consumption in the first 24 hours postoperatively, compared with standard analgesia (MD = -19.55; 95% CI [-28.50, -10.60]; P < 0.0001, I2 = 72%) and other regional blocks (MD = -13.15; 95% CI [-24.77, -1.52]; P = 0.03, I2 = 95%). Heterogeneity was considered moderate to high among studies, related to differences in samples, anesthetic protocols, and assessment methods. Outcomes associated with postoperative pain have a low to very low quality of evidence according to the GRADE method.</p><p><strong>Discussion: </strong>The findings support the clinical potential of EOIPB as an effective strategy for postoperative pain control, but without indication for adoption in clinical practice routine, limited to situations of failure of first-line techniques in analgesia, such as epidural anesthesia.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain Distribution and its Association With Neuropathic Pain Features and Assumed Central Sensitization in Acute Whiplash-Associated Disorders: A Cross-Sectional Study.","authors":"Fernando De-La-Rosa-Castilla, Ernesto Anarte-Lazo, Deborah Falla, Carlos Bernal-Utrera, Cleofás Rodríguez-Blanco, Marco Barbero","doi":"10.1097/AJP.0000000000001394","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001394","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate pain distribution in people with acute whiplash associated disorders (WAD) and explore its association with neuropathic pain and assumed central sensitization features. Although widespread pain is common after a whiplash injury, the relationship between pain extent (the area of the body perceived as painful) and underlying pain-related mechanisms in acute WAD remains poorly understood.</p><p><strong>Methods: </strong>In this cross-sectional study, 124 individuals (mean age: 39.7±11.2 y; 67 females) with acute WAD grade II (7-30 d post-injury) completed questionnaires assessing neck pain intensity, disability, neuropathic pain (S-LANSS), and assumed central sensitization (CSI). Pain drawings were analyzed with a validated image-processing algorithm to quantify pain extent. Correlation and multiple linear regression analyses were performed to identify predictors of pain extent.</p><p><strong>Results: </strong>Bivariate correlations showed that pain extent was significantly associated with all clinical variables, with the strongest correlation observed between pain extent and S-LANSS (ρ=0.816, P<.001). In the multiple regression model, only S-LANSS was a significant predictor of PE (β=0.705, P<.001), explaining 64% of the variance. A moderate correlation (ρ=0.437) was found between CSI and pain extent, but the CSI did not independently predict pain extent. No sex differences were observed for any clinical variable.</p><p><strong>Discussion: </strong>This is the first study to show a strong association between neuropathic pain features and widespread pain in people with acute WAD. These findings highlight the potential utility of assessing pain extent and neuropathic pain features to identify pain phenotypes early after injury which may support more individualized treatment approaches.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a Modified Cocktail for Quadratus Lumborum Block combined With Periarticular Local Infiltration Analgesia in Total Hip Arthroplasty.","authors":"Yan Zeng, Jian Hu, Jing Yang, Jun Ma","doi":"10.1097/AJP.0000000000001391","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001391","url":null,"abstract":"<p><strong>Objectives: </strong>Quadratus lumborum block(QLB) and periarticular local infiltration analgesia(LIA) are both widely used for postoperative pain control in total hip arthroplasty. The additive benefit of using a modified anesthetic cocktail remains uncertain when both techniques incorporate active adjuvants.</p><p><strong>Methods: </strong>In this randomized controlled trial, 70 patients undergoing unilateral total hip arthroplasty under general anesthesia were randomized to receive either QLB combined with LIA (QLB+LIA group) or LIA alone. Both groups received an identical modified analgesic cocktail composed of ropivacaine, dexamethasone, magnesium sulfate, and sodium bicarbonate. The primary outcome was total opioid consumption within 24 hours postoperatively. Secondary outcomes included intraoperative remifentanil usage, numerical rating scale pain scores, plasma ropivacaine concentrations, quadriceps muscle strength, daily walking distance, quality of recovery-15 score, inflammatory markers , and adverse events.</p><p><strong>Results: </strong>Compared to the LIA group, the QLB+LIA group showed significantly reduced 24-hour opioid consumption (12.7±4.7 mg vs. 16.2±7.3 mg; P=0.026) and intraoperative remifentanil use (P=0.034). Numerical rating scale pain scores during mobilization at 12 and 24 hours were lower in the QLB+LIA group. No differences were observed in functional recovery or inflammatory responses. Plasma ropivacaine levels remained below toxicity thresholds in both groups.</p><p><strong>Conclusion: </strong>Compared with LIA alone, added LIA to QLB with a modified cocktail can reduce the use of opioids and reduce the postoperative pain score during mobilization within 24 hours after the operation.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Dorsal Root Ganglion Pulse Radiofrequency Combined With Sympathetic Radiofrequency Ablation in the Treatment of Acute Herpetic Neuralgia.","authors":"Ping Xu, Mingqing Yu, Hanrui Fan, Yong Fei","doi":"10.1097/AJP.0000000000001390","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001390","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the efficacy and safety of pulsed radiofrequency combined with sympathetic radiofrequency ablation of dorsal root ganglion in the treatment of acute herpetic neuralgia.</p><p><strong>Methods: </strong>A total of 116 patients diagnosed with acute herpetic neuralgia were randomly assigned to two groups: a dorsal root ganglion pulsed radiofrequency group (Group C) and a dorsal root ganglion pulsed radiofrequency combined with sympathetic radiofrequency ablation group (Group H). The treatment effects were evaluated using the Numerical Rating Scale, the Pittsburgh Sleep Quality Index, the proportion of patients utilizing tramadol, and the Current Perception Threshold detection. Additionally, serum levels of Galectin-3 and Interleukin-6 were measured as objective biological indicators to assess the therapeutic efficacy. The incidence of Postherpetic Neuralgia and any complications were recorded for both groups.</p><p><strong>Results: </strong>Data showed that compared with group C, the Numerical Rating Scale, Pittsburgh Sleep Quality Index score, the proportion of patients using tramadol, and serum Galectin-3 and Interleukin-6 levels were significantly decreased, and Current Perception Threshold was significantly increased in group H (P<0.05). The incidence of Postherpetic Neuralgia in group H was significantly lower than that in group C. No serious adverse reactions occurred in the two groups after treatment.</p><p><strong>Discussion: </strong>Dorsal root ganglion pulsed radiofrequency combined with sympathetic radiofrequency ablation is more effective in the treatment of acute herpetic neuralgia. Compared with PRF therapy alone, it provides patients with longer lasting pain relief, reduces the incidence of PHN, and improves the quality of life.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Pain-Related Kinesiophobia and Sedentary Behavior in Older Patients with Lumbar Spine Disease.","authors":"Kohei Okawa, Yushin Yamamoto, Iwao Kojima, Yusuke Terao, Shu Tanaka, Hiroki Saegusa, Miho Nambu, Hiroki Matsumoto, Masaya Saito, Shiho Soma, Naoto Haga, Hiromu Suzuki, Yuzuru Takahashi, Masahiro Suzuki, Minoru Yamada","doi":"10.1097/AJP.0000000000001389","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001389","url":null,"abstract":"<p><strong>Objectives: </strong>In older patients with lumbar spine disease, kinesiophobia caused by pain may influence SB independent of physical activity (PA). Understanding this association may lead to the development of new non-pharmacological strategies for managing such patients. The present study aimed to investigate whether pain-related kinesiophobia influences sedentary behavior (SB) in older patients with lumbar spine disease.</p><p><strong>Methods: </strong>This study included 106 outpatients with lumbar spine disease, all aged > 65 years. The outcome measurements were daily step count and self-reported daily SB, calculated as the average of seven consecutive days. Kinesiophobia was assessed using the Tampa scale for kinesiophobia (TSK). Statistical analyses were performed using multiple regression analysis.</p><p><strong>Results: </strong>The mean age of the participants was 77.6 ± 5.9 years, and 70 of them (77.0%) were female. The median (interquartile range) Visual Analog Scale score for pain and numbness was 23.9 (10.4-47.2) mm. The median daily step count was 3627.3 (2166.9-4419.9) steps per day, and the mean daily SB was 424.9 ± 165.6 minutes per day. The mean TSK score was 40.5 ± 4.7. Multiple regression analysis revealed that both daily step count (B=-0.01, β=-0.22, 95% confidence interval [CI]=-0.02-0.00, P=0.032) and SB (B=10.33, β=0.29, 95% CI=3.00-17.69, P=0.006) were independently associated with the TSK score.</p><p><strong>Discussion: </strong>Our results suggest that increased kinesiophobia may be associated with increased SB, independent of PA. Addressing kinesiophobia in older patients with lumbar spine disease may prevent a decrease in PA and increase in SB, thereby offering a new treatment strategy.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transversus Abdominis Plane Block With Dexmedetomidine and Local Anesthetics compared with Local Anesthetics Isolated for Patients Undergoing Cesarean Section: A Systematic Review and Meta-Analysis.","authors":"Laiz G C Novaes, Daniel M Oliveira, André B Donato, Priscila F DE L E Souza, Thomas R Erdmann","doi":"10.1097/AJP.0000000000001385","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001385","url":null,"abstract":"<p><strong>Objectives: </strong>Dexmedetomidine is a short-term sedative used for peripheral nerve blockade and spinal anesthesia. This meta-analysis evaluated efficacy and safety of dexmedetomidine in TAP block in C-section.</p><p><strong>Methods: </strong>A systematic search across online databases comparing dexmedetomidine with local anesthetics to local anesthetics isolated in TAP block for women undergoing spinal anesthesia for cesarean section. Significance was defined at P<0.05 for odds ratios (OR), mean differences (MD), and standard mean differences (SMD). Heterogeneity weas evaluated using I² statistics. Twelve randomized controlled trials (RCTs) encompassing 799 patients were included.</p><p><strong>Results: </strong>Dexmedetomidine delayed the consumption of first analgesic (MD 3.69; [95% CI 2.93-4.45]; P<0.00001; I²=86%) in the postoperative period; decreased the amount of rescue intravenous tramadol consumption (MD -13.61; [95% CI -24.56--2.67]; P=0.01; I²=85%), the number of patients who required rescue analgesic (OR 0.25; [95% CI 0.13-0.49]; P<0.00001; I²=42%) and the VAS scores at 6h (MD -1.48; [95% CI -1.65--1.30]; P<0.0001; I²=70%), at 12h (MD -0.92; [95% CI -1.60--0.24]; P=0.008; I²=90%) and at 24h (MD -0.50; [95% CI -0.93--0.08]; P=0.02; I²=92%). When patient satisfaction score was analyzed, there was also a significant difference between groups (SMD 1.07; [95% CI 0.76-1.39]; P<0.00001; I²=0%).</p><p><strong>Discussion: </strong>Dexmedetomidine with local anesthetics was associated with a delay in consumption of the first analgesic in the postoperative period, decrease in the amount of rescue intravenous tramadol and in the VAS scores at 6, 12 and 24 hours. However, the GRADE assessment of the quality of evidence was 'low' due to the high risk of bias and heterogeneity.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Cognitive Dysfunction and Analgesic Outcomes in Cardiac Surgery: Evaluating the Role of Nerve Block Techniques.","authors":"Mengxue Yan, Kaining Wang, Haoqi Yan, Su Yuan","doi":"10.1097/AJP.0000000000001388","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001388","url":null,"abstract":"<p><strong>Objective: </strong>Cardiac surgery frequently induces moderate to severe postoperative pain, which impedes recovery and elevates the risk of opioid dependence and postoperative cognitive dysfunction. This review aims to outline peripheral nerve block approaches in cardiac surgery and examine their analgesic efficacy and potential relationship with postoperative cognitive dysfunction.</p><p><strong>Materials and methods: </strong>A comprehensive literature search was performed using the electronic databases PubMed, EMBASE, and Google Scholar for publications up to September 2025. Search terms included regional anesthesia, nerve block, pain management, delirium, cognitive dysfunction, and cardiac surgery. The retrieved literature, including clinical reviews, basic research, clinical trials, and guidelines, was screened and prioritized based on thematic relevance and the strength of clinical evidence. The available evidence was synthesized into a narrative review.</p><p><strong>Results: </strong>The evidence suggests that nerve blocks are an effective component of a multimodal analgesic strategy, significantly reducing postoperative opioid consumption and attenuating neuroinflammatory responses such as microglial activation. However, they have not been conclusively shown to reduce the incidence of postoperative cognitive dysfunction. Current implementation faces challenges including a lack of technique standardization and the need to adapt to heterogeneous surgical anatomies.</p><p><strong>Discussion: </strong>Nerve blocks are valuable for opioid-sparing analgesia and may modulate neuroinflammation, but their role in preventing postoperative cognitive dysfunction remains unproven. Future efforts should focus on standardizing protocols and conducting mechanistic studies to clarify the relationship between nerve blocks, neuroinflammatory modulation, and long-term neurological outcomes.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analgesic Effects of Intravenous Lidocaine in Laparoscopic Surgery: A Systematic Review and Meta-analysis With Trial Sequential Analysis.","authors":"Ka Ting Ng, Wei En Lim, Wan Yi Teoh, Mohd Fitry Bin Zainal Abidin","doi":"10.1097/AJP.0000000000001386","DOIUrl":"https://doi.org/10.1097/AJP.0000000000001386","url":null,"abstract":"<p><strong>Objectives: </strong>Recent studies have showed that intravenous lidocaine is associated with reducing postoperative pain. However, the mechanism of action of intravenous lidocaine as a part of multi-modal analgesic regimen on patients undergoing laparoscopic surgery remains unclear. The primary aim was to demonstrate the effects of intravenous lidocaine on postoperative pain score in adults undergoing laparoscopic surgery.</p><p><strong>Methods: </strong>Databases of MEDLINE, EMBASE, and CENTRAL were searched since 1947 until May 2023. Randomized clinical trials (RCT) comparing intravenous lidocaine and placebo in adults undergoing surgery were included.</p><p><strong>Results: </strong>Forty-five RCTs (n=2,599) were included. Intravenous lidocaine group was associated with significantly lower postoperative pain scores at rest (MD: -0.27, 95% CI: -0.45 to -0.08, P=0.005) at the 24-hour after surgery and during movement (MD: -0.58, 95% CI: -0.89 to -0.27, P<0.001). Intravenous lidocaine significantly decreased fentanyl consumption (MD: -14.46, 95% CI: -18.11 to -10.81, P<0.001) and morphine consumption (MD: -3.63, 95% CI: -5.12 to -2.13, P<0.001) postoperatively. It also significantly lowered the incidence of nausea and vomiting (RR: 0.66, 95% CI: 0.54 to 0.81, P<0.001) and reduced time to flatus (MD: -5.90, 95% CI: -8.18 to -3.62, P<0.001).</p><p><strong>Discussions: </strong>This systematic reinforces the potential role of adding intravenous lidocaine as part of multimodal analgesia in the reduction of postoperative pain, opioid consumption, incidence of nausea and vomiting, and the time to flatus. However, our findings should be interpreted with caution owing to low level of evidence and high degree of heterogeneity.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}