Key result
Perioperative vitamin C significantly reduced postoperative pain scores within 1-2 hours compared to placebo (SMD -0.68; 95% CI -1.01 to -0.36; p<0.0001).
Why the study?
The analgesic effect of vitamin C against acute pain remains poorly addressed, prompting an investigation into its effectiveness against acute postoperative pain.
Does perioperative vitamin C reduce postoperative pain and morphine consumption in surgical patients?
Meta-Analysis
Does perioperative vitamin C reduce postoperative pain and morphine consumption in surgical patients?
Perioperative vitamin C, particularly when administered intravenously, significantly reduces acute postoperative pain and opioid requirements up to 24 hours.
Answers are grounded in this paper and cite their sources.
Supports adjunctive perioperative vitamin C for early postoperative pain; strengthens meta-analytic evidence for opioid-sparing strategies in surgery.
Because the analgesic effect of vitamin C against acute pain remains poorly addressed, this meta-analysis aimed at investigating its effectiveness against acute postoperative pain. A total of seven randomized controlled trials with placebo/normal controls were identified from PubMed, Cochrane Library, Medline, Google Scholar, and Embase databases. Pooled analysis showed a lower pain score (standardized mean difference (SMD) = −0.68, 95% CI: −1.01 to −0.36, p < 0.0001; I2 = 57%) and a lower morphine consumption (weighted mean difference (WMD) = −2.44 mg, 95% CI: −4.03 to −0.86, p = 0.003; I2 = 52%) in the vitamin group than that in the placebo group within postoperative 1–2 h. At postoperative 24 h, a lower pain score (SMD = −0.65, 95% CI: −1.11 to −0.19, p = 0.005; I2 = 81%) and lower morphine consumption (WMD = −6.74 mg, 95% CI: −9.63 to −3.84, p < 0.00001; I2 = 85%) were also noted in the vitamin group. Subgroup analyses demonstrated significant reductions in pain severity and morphine requirement immediately (1–2 h) and 24 h after surgery for patients receiving intravenous vitamin C but not in the oral subgroup. These findings showed significant reductions in pain score and opioid requirement up to postoperative 24 h, respectively, suggesting the effectiveness of perioperative vitamin C use. Further large-scale trials are warranted to elucidate its optimal intravenous dosage and effectiveness against chronic pain in the postoperative pain control setting.
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Hung et al. (2020) conducted a meta-analysis in acute postoperative pain. Perioperative vitamin C vs. Placebo/normal controls was evaluated on Pain score within postoperative 1-2 h (SMD -0.68, 95% CI -1.01 to -0.36, p=< 0.0001). Perioperative vitamin C significantly reduced postoperative pain scores within 1-2 hours compared to placebo (SMD -0.68; 95% CI -1.01 to -0.36; p<0.0001).
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