Published online Feb 26, 2022. doi: 10.12998/wjcc.v10.i6.1852
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
Processing time: 219 Days and 10 Hours
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.
No meta-analysis has summarized evidence to assess the value of adding opioids to PVB in breast cancer patients undergoing surgical intervention.
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.
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.
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.
Current evidence suggests a limited role of adjuvant opioids with PVB for breast cancer surgery patients.
Further homogenous RCTs with a large sample size are needed to clarify the beneficial role of opioids with PVB.