Analgesic potential of transdermal nicotine patch in surgery: a systematic review and meta-analysis of randomised placebo-controlled trials

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dc.contributor.authorda Silva Barbirato, Davi
dc.contributor.authorde Melo Vasconcelos, Amanda Freire
dc.contributor.authorDantas de Moraes, Sandra Lúcia
dc.contributor.authorPellizzer, Eduardo Piza [UNESP]
dc.contributor.authordo Egito Vasconcelos, Belmiro Cavalcanti
dc.contributor.institutionUniversity of Pernambuco (UPE)
dc.contributor.institutionUniversidade Federal de Pernambuco (UFPE)
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionOral and Maxillofacial Surgery at Hospital da Restauração
dc.date.accessioned2023-07-29T16:09:03Z
dc.date.available2023-07-29T16:09:03Z
dc.date.issued2023-05-01
dc.description.abstractObjectives: We aimed (1) to systematically review the efficacy of transdermal nicotine patches (NP) for postoperative analgesia, (2) to establish the current quality of evidence and assist clinical decision-making on the subject, and (3) to identify methodological limitations and the need for more well-designed studies. Materials and methods: We searched six electronic databases, protocol records, and other sources without date or language restriction until March 2022. To develop the search strategy, we formulated a clinical question by using the PICOD method. Eligibility criteria included randomised placebo-controlled trials on the analgesic potential of NP for surgical procedures. This systematic review followed the PRISMA 2020 statement, and we registered the protocol in PROSPERO (#CRD42020205956). Results: We included 10 randomised placebo-controlled trials (535 patients). The NP administered before induction of anaesthesia and at beginning of surgery reduced the pain immediately after surgery (−0.38; 95% confidence interval [CI]: −0.73 to −0.02), and 6 h (−0.34; 95% CI: −0.68 to −0.01), 12 h (−0.43; 95% CI: −0.71 to −0.15) and 24 h (−0.35; 95%CI: −0.59 to −0.10) after surgery, compared with the placebo patch (PP) group. Sensitivity testing suggests that opioid use could underestimate NP analgesia. Late demand for the first analgesic and consumption of rescue analgesics tended to be lower in the NP group. Conclusions: The current findings suggest, with low certainty of evidence, the analgesic potential of NP for surgical procedures. Clinical relevance: Perioperative use of NP significantly improved postoperative pain, even when opioids were administered or prescribed. Nevertheless, the clinical relevance should be interpreted with caution, owing to the effect sizes of the summary measures and methodological issues. The analgesic potential of NP as an adjuvant therapy to regulate pain and acute inflammation may offer certain clinical advantages, thus warranting further investigation.en
dc.description.affiliationDivision of Oral and Maxillofacial Surgery Dental School University of Pernambuco (UPE), Arnóbio Marques St., 310, PE
dc.description.affiliationFederal University of Pernambuco (UFPE), PE
dc.description.affiliationFaculty of Dentistry University of Pernambuco (UPE), PE
dc.description.affiliationDepartment of Dental Materials and Prosthodontics São Paulo State University (UNESP)
dc.description.affiliationOral and Maxillofacial Surgery at Hospital da Restauração, PE
dc.description.affiliationUnespDepartment of Dental Materials and Prosthodontics São Paulo State University (UNESP)
dc.format.extent589-607
dc.identifierhttp://dx.doi.org/10.1007/s00228-023-03475-7
dc.identifier.citationEuropean Journal of Clinical Pharmacology, v. 79, n. 5, p. 589-607, 2023.
dc.identifier.doi10.1007/s00228-023-03475-7
dc.identifier.issn1432-1041
dc.identifier.issn0031-6970
dc.identifier.scopus2-s2.0-85150501610
dc.identifier.urihttp://hdl.handle.net/11449/249781
dc.language.isoeng
dc.relation.ispartofEuropean Journal of Clinical Pharmacology
dc.sourceScopus
dc.subjectMeta-analysis
dc.subjectNicotine patch
dc.subjectOpioids
dc.subjectPain management
dc.subjectPerioperative period
dc.subjectPostoperative pain
dc.subjectPreoperative procedure
dc.titleAnalgesic potential of transdermal nicotine patch in surgery: a systematic review and meta-analysis of randomised placebo-controlled trialsen
dc.typeResenha

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