{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:32:32Z","timestamp":1747182752013,"version":"3.40.5"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T00:00:00Z","timestamp":1608681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Hip fracture is a common, painful injury with increasing global incidence. Patients require optimal acute pain management. Systematic reviews have investigated the postoperative use of epidural analgesia and found that it may have advantages over systemic analgesia. It is of interest to determine whether pre\u2010operative use of epidural analgesia is also advantageous.<\/jats:p><jats:p>We conducted a systematic review and meta\u2010analyses on the effect of epidural analgesia on pre\u2010operative pain management in hip fracture patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included randomized controlled trials comparing pre\u2010operatively initiated epidural analgesia with any other method of analgesia, in adults aged \u226555\u00a0years scheduled for hip fracture surgery. The main outcome was pre\u2010operative pain at rest. Electronic searches of four medical databases were performed. Two authors independently screened for eligibility, extracted data, and assessed risk of bias. We conducted meta\u2010analyses and assessed the certainty of the evidence by Grading of Recommendations Assessment, Development and Evaluation (GRADE).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three articles were included, with 179 randomized patients. All studies compared epidural analgesia with systemic analgesia, one additionally with 3\u2010in\u20101\u2010block. Meta\u2010analyses of pre\u2010operative pain measurements resulted in a mean difference of \u22125.85 95% CI [\u221214.90; 3.19] on a 0\u2010100 Visual Analogue Scale with a <jats:italic>p<\/jats:italic>\u2010value of 0.17 and a very low certainty of evidence according to the GRADE rating.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We did not find a difference in pre\u2010operative pain at rest between epidural analgesia and any other method of pre\u2010operatively initiated analgesia. The studies were few, of low quality and the difference between the two interventions remains unknown.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13760","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T19:18:07Z","timestamp":1607627887000},"page":"578-589","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pre\u2010operative epidural analgesia in hip fracture patients \u2010 A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8711-921X","authenticated-orcid":false,"given":"Monika Afzali","family":"Rubin","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Herlev\u2010Gentofte University Hospital Herlev Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaj Francis","family":"Stark","sequence":"additional","affiliation":[{"name":"Emergency Department Holb\u00e6k Hospital Holb\u00e6k Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon Julius Chamli","family":"H\u00e5rsmar","sequence":"additional","affiliation":[{"name":"MD, Psychiatric Clinic Lund Region Sk\u00e5ne Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ann Merete","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Herlev\u2010Gentofte University Hospital Herlev Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-016-0332-0"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.3278"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-012-1964-3"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01623184"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00004148"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1462"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-007-0543-5"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/8756-3282(95)00383-5"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a008690"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.130901"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/58.1.M76"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200511000-00023"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7275.1493"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-020-01074-y"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2017.09.002"},{"key":"e_1_2_9_17_1","first-page":"CD010108","article-title":"Neuraxial blockade for the prevention of postoperative mortality and major morbidity: an overview of Cochrane systematic reviews","volume":"2014","author":"Guay J","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/aas.13615"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200506000-00020"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-4-201108160-00346"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/17453678008990877"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.43B4.647"},{"key":"e_1_2_9_23_1","article-title":"Preoperative epidural analgesia in hip fracture patients: a systematic review and meta\u2010analysis","author":"Stark NF","year":"2020","journal-title":"Acta Anaesthesiol Scand"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200301000-00025"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/2151458512470953"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2000.440905.x"},{"key":"e_1_2_9_29_1","unstructured":"Covidence systematic review software.Melbourne Australia:Veritas Health Innovation."},{"key":"e_1_2_9_30_1","unstructured":"Nordic Cochrane Centre. 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