Impact of Regional Anesthesia on Subjective Quality of Recovery in Patients Undergoing Thoracic Surgery: A Systematic Review and Meta-Analysis

Objectives: Regional anesthesia can be effective for managing pain after thoracic surgery. This study evaluated whether it can also improve patient-reported quality of recovery (QoR) after such surgery. Design: Meta-analysis of randomized controlled trials. Setting: Postoperative care. Intervention: Perioperative regional anesthesia. Patients: Adults undergoing thoracic surgery. Measurements and Main Results: The primary outcome was total QoR scores 24 hours after surgery. Secondary outcomes were postoperative opioid consumption, pain scores, pulmonary function, respiratory complications, and other adverse effects. Eight studies were identified, of which 6 involving 532 patients receiving video-assisted thoracic surgery were included in the quantitative analysis of QoR. Regional anesthesia significantly improved QoR-40 score (mean difference 9.48; 95% CI 3.53-15.44; I2 = 89%; 4 trials involving 296 patients) and QoR-15 score (mean difference 6.7; 95% CI 2.58-10.82; I2 = 0%; 2 trials involving 236 patients). Regional anesthesia also significantly reduced postoperative opioid consumption and the incidence of nausea and vomiting. Insufficient data were available to meta-analyze the effects of regional anesthesia on postoperative pulmonary function or respiratory complications. Conclusions: The available evidence suggests that regional anesthesia can enhance QoR after video-assisted thoracic surgery. Future studies should confirm and extend these findings. & COPY; 2023 Elsevier Inc. All rights reserved.