{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T09:20:27Z","timestamp":1787908827591,"version":"build-2784847793"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T00:00:00Z","timestamp":1730937600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative pain following video\u2010assisted thoracoscopic surgery (VATS) remains a significant challenge. While epidural analgesia is still the gold standard, other types of regional analgesia are gaining popularity because of perceived less risk of complications. The efficacy of systemic opioids as an alternative to epidural analgesia has not been thoroughly explored. This systematic review and meta\u2010analysis aims to evaluate and compare the efficacy of systemic opioids versus epidural analgesia in managing postoperative pain after VATS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We will conduct a systematic review and meta\u2010analysis in accordance with the Cochrane Handbook and the Preferred Reporting Items for Systematic review and Meta\u2010Analysis Protocols (PRISMA\u2010P) checklist. A comprehensive search will be conducted in MEDLINE, EMBASE, and the Cochrane Library supplemented with Scopus citation searches, search for gray literature using Google Scholar and a search for ongoing studies. We will include studies based on the PICO methodology without restrictions regarding study type. Two independent reviewers will screen studies, extract data, and assess study quality using the Cochrane Risk of Bias tools. The primary outcomes will be postoperative pain intensity at rest and during activity at 24, 48, and 72\u2009h. Secondary outcomes will include use of \u201crescue\u201d opioids, hospital length of stay, and adverse events. If feasible, a meta\u2010analysis will be done, otherwise we will perform a descriptive analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results will provide a comparative analysis of the effectiveness of systemic opioids versus epidural analgesia in managing postoperative pain in VATS patients. Data synthesis will include pooled estimates for pain scores, opioid consumption, and adverse events, possibly with subgroup and sensitivity analyses conducted to explore heterogeneity across studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This systematic review will offer valuable insights into the optimal pain management strategy for patients undergoing VATS. The findings may guide clinical practice in selecting the most effective and safe analgesic approach, improving postoperative recovery, and patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.14546","type":"journal-article","created":{"date-parts":[[2024,11,7]],"date-time":"2024-11-07T04:29:06Z","timestamp":1730953746000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Epidural analgesia versus systemic opioids for postoperative pain management after\n                    <scp>VATS<\/scp>\n                    : Protocol for a systematic review"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5819-2952","authenticated-orcid":false,"given":"Jimmy H.","family":"Holm","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikkel","family":"Bak","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6453-6152","authenticated-orcid":false,"given":"Anne C.","family":"Br\u00f8chner","sequence":"additional","affiliation":[{"name":"Department of Regional Health Research University of Southern Denmark  Odense Denmark"},{"name":"Department of Anesthesiology and Intensive Care Medicine, Kolding Hospital  Kolding Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S144066"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001243"},{"issue":"8","key":"e_1_2_9_4_1","first-page":"892","article-title":"AAAPT diagnostic criteria for acute thoracic surgery pain","volume":"22","author":"Bayman EO","year":"2021","journal-title":"J P"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)00173-X"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)02804-1"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/14017431.2015.1114665"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.12.83"},{"issue":"1","key":"e_1_2_9_9_1","article-title":"Acute pain management after thoracoscopic lung resection: a systematic review and explorative meta\u2010analysis","volume":"36","author":"Spaans LN","year":"2023","journal-title":"Interdiscip Cardiovasc Thorac Surg"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.15609"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy301"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2011.04.010"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezt525"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezx413"},{"key":"e_1_2_9_15_1","unstructured":"PROSPERO International prospective register of systematic review. Available from:https:\/\/www.crd.york.ac.uk\/prospero\/"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g7647"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-4-1"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513497567"},{"key":"e_1_2_9_19_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.5","author":"Li T","year":"2024"},{"key":"e_1_2_9_20_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.4","author":"Higgins JPT","year":"2023"},{"key":"e_1_2_9_21_1","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.4","author":"Sterne JAC","year":"2023"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-079849"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0308335"},{"key":"e_1_2_9_24_1","article-title":"Epidural analgesia versus patient\u2010controlled intravenous analgesia for pain following intra\u2010abdominal surgery in adults","volume":"8","author":"Salicath JH","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6890"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13741-020-00159-z"}],"container-title":["Acta Anaesthesiologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.14546","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aas.14546","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aas.14546","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T08:38:59Z","timestamp":1787906339000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aas.14546"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,7]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1111\/aas.14546"],"URL":"https:\/\/doi.org\/10.1111\/aas.14546","archive":["Portico"],"relation":{},"ISSN":["0001-5172","1399-6576"],"issn-type":[{"value":"0001-5172","type":"print"},{"value":"1399-6576","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,7]]},"assertion":[{"value":"2024-10-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-11-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14546"}}