Pharmacological Therapies for Pain Management in Patients With Amputation: A Systematic Review and Network Meta-Analysis
Abstract
Objective: To evaluate the efficacy and safety of pharmacological therapies for pain management in postamputation patients through a systematic review and network meta-analysis of existing evidence.
Methods: This systematic review and network meta-analysis (NMA) was conducted following the PRISMA-NMA guidelines and registered in PROSPERO (CRD42024500600). In September 2024, two independent reviewers searched the Cochrane Library, LILACS, PubMed/MEDLINE, SciELO, ScienceDirect, Web of Science, Scopus, CINAHL, and Google Scholar. The eligibility criteria included systematic reviews (with or without meta-analysis) evaluating pharmacological interventions in populations aged 18 years or older.
Results: Seventeen studies met the inclusion criteria and were described in narrative form. Among these studies, seven systematic reviews of randomized clinical trials contained data suitable for NMA. Two primary outcomes were assessed: residual limb pain and phantom limb pain. Analysis of the three subnetworks revealed no statistically significant differences in either direct or indirect comparisons across the evaluated therapies.
Conclusion: Current evidence is insufficient to support the efficacy and safety of specific pharmacological therapies for pain management in patients with amputation compared to placebo or alternative treatments.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Effect of dexamethasone as an analgesic adjuvant to multimodal pain treatment after total knee arthroplasty: randomised clinical trial
- Effect of a Postoperative Multimodal Opioid-Sparing Protocol vs Standard Opioid Prescribing on Postoperative Opioid Consumption After Knee or Shoulder Arthroscopy: A Randomized Clinical Trial
- Comparison of the Post-Caesarean Analgesic Effect of Adding Dexmedetomidine to Paracetamol and Ketorolac: A Randomized Clinical Trial
- A triple-blind randomized clinical trial of different associations between dexamethasone and non-steroids anti-inflammatories for preemptive action in third molar extractions
- An open label randomized clinical trial of Indomethacin for mild and moderate hospitalised Covid-19 patients
- Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.