Chen MH, Chen Z, Zhao D. Impact of adding opioids to paravertebral blocks in breast cancer surgery patients: A systematic review and meta-analysis. World J Clin Cases 2022; 10(6): 1852-1862 [PMID: 35317143 DOI: 10.12998/wjcc.v10.i6.1852]
Corresponding Author of This Article
Da Zhao, MD, Doctor, Department of Oncology, The First Hospital of Lanzhou University, No. 1 Donggang West Road, Lanzhou 730000, Gansu Province, China. zhaoda_dr@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 26, 2022; 10(6): 1852-1862 Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.1852
Impact of adding opioids to paravertebral blocks in breast cancer surgery patients: A systematic review and meta-analysis
Meng-Hua Chen, Zheng Chen, Da Zhao
Meng-Hua Chen, Lanzhou University Medical College, Lanzhou 730000, Gansu Province, China
Zheng Chen, Department of Breast, Shandong Second Provincial General Hospital, Jinan 250021, Shandong Province, China
Da Zhao, Department of Oncology, The First Hospital of Lanzhou University, Lanzhou 730000, Gansu Province, China
Author contributions: Chen MH conceived and designed the study, analyzed the data, and wrote the paper; Chen Z and Zhao D were involved in literature search and data collection and reviewed and edited the manuscript; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Da Zhao, MD, Doctor, Department of Oncology, The First Hospital of Lanzhou University, No. 1 Donggang West Road, Lanzhou 730000, Gansu Province, China. zhaoda_dr@163.com
Received: July 19, 2021 Peer-review started: July 19, 2021 First decision: October 16, 2021 Revised: October 21, 2021 Accepted: January 19, 2022 Article in press: January 19, 2022 Published online: February 26, 2022
ARTICLE HIGHLIGHTS
Research background
Opioids have been used in combination with local anesthetics for several locoregional anesthetic techniques, leading to better pain control in the immediate postoperative period. However, it is not known if the addition of opioids to paravertebral block (PVB) would lead to better outcomes in breast cancer patients.
Research motivation
No meta-analysis has summarized evidence to assess the value of adding opioids to PVB in breast cancer patients undergoing surgical intervention.
Research objectives
To compare total analgesic consumption, time to first analgesic request, and pain scores with and without the addition of opioids to PVB in breast cancer surgery patients.
Research methods
We conducted an electronic literature search across PubMed, Embase, Scopus, and Google Scholar databases up to October 20, 2020 for randomized controlled trials (RCTs) comparing the addition of opioids to PVB with placebo for breast cancer surgery patients.
Research results
Analysis of six RCTs demonstrated that the addition of opioids to PVB significantly reduced 24-h total analgesic consumption but had no impact on the time to first analgesic request. Pain scores at 24 h were marginally lower with the addition of opioids.
Research conclusions
Current evidence suggests a limited role of adjuvant opioids with PVB for breast cancer surgery patients.
Research perspectives
Further homogenous RCTs with a large sample size are needed to clarify the beneficial role of opioids with PVB.
